Handling aftercare enquiries: a front desk process for clinics

Most aftercare messages are simple. "Can I go to the gym tomorrow?" "When is my review?" A few are not. A patient describing a change in colour or worsening pain hours after a filler treatment needs a clinician now, not a reply in the morning. The job of the front desk, human or AI, is to tell the difference quickly and send each message to the right person.

What the professional guidance expects

• An out-of-hours contact. The GMC's guidance for doctors who offer cosmetic interventions says patients must know how to contact the doctor, or another named, suitably qualified person, if they have complications outside normal working hours. The JCCP and CPSA code for practitioners says the same, and Save Face's accreditation standards require out-of-hours contact details for emergencies.
• Written aftercare information. The GMC says patients should be given written information about the treatment they received, in enough detail for another professional to take over their care.
• A way to report problems. The JCCP code says practitioners must tell patients how to report complications and adverse reactions.
• In-person review when it matters. Guidance from the Aesthetic Complications Expert (ACE) Group says that if a patient reports symptoms consistent with a vascular occlusion, an immediate in-person review should be arranged, and that doing this through electronic media is not acceptable.

In other words, a WhatsApp exchange is never a substitute for a clinician seeing the patient when something may be wrong.

Triage: three kinds of message

1. Routine. Admin and questions that your written aftercare sheet already answers. Booking or moving a review, receipts, directions, or "where's my aftercare leaflet?" Reception can handle these, by pointing to the clinic's own written information rather than interpreting it.

2. Needs a practitioner. Anything about how the patient looks or feels. A question about a symptom, a photo of the treated area, "is this normal?", unhappiness with the result, or a request for a top-up. These go to a practitioner the same day, with a clear holding reply to the patient.

3. Urgent. Symptoms your clinicians have listed in advance as needing immediate contact. Agree the list with them and keep it in writing. The ACE Group's guidance on vascular occlusion, for example, describes:

• sudden or worsening pain, or pain away from the injection site;
• skin that looks pale, white or dusky, or blue, grey or purple discolouration that develops in the hours after treatment;
• problems with vision after a filler treatment (the ACE Group notes reported cases of visual loss linked to injections in some areas of the face).

A message like this goes to the on-call clinician immediately, by phone, not into a queue. Anything that sounds like a medical emergency, such as difficulty breathing, means telling the patient to call 999 straight away, then alerting the clinician. The ACE Group's emergency kit guidance says patients treated for anaphylaxis should go to hospital by ambulance.

Escalation routes and out-of-hours cover

1. Name the on-call clinician for every hour the clinic is closed, including weekends and holidays, and keep the rota where reception can see it.
2. Give patients the number. Put the out-of-hours contact on the aftercare sheet and in the post-treatment message.
3. Have a backup. If the on-call clinician doesn't answer within a set time, who is next? The ACE Group advises less experienced practitioners to seek advice quickly from a more experienced colleague.
4. Never leave an urgent message in an inbox. Urgent means a phone call to a person, every time.

Response times

The guidance we found doesn't set fixed response times for aftercare messages, so set your own and write them down. A sensible starting point:

• Urgent: passed to a clinician immediately, at any hour.
• Needs a practitioner: an acknowledgement straight away, and a practitioner reply the same working day.
• Routine: answered within normal opening hours.

Whatever you choose, tell the patient honestly when they will hear back.

Who replies

Reception handles admin. Practitioners handle anything clinical, ideally the person who treated the patient, or the named on-call clinician. If a concern arrives as a public comment on Instagram or Facebook, reply briefly and move it to a private channel. Save Face's standards say clinicians must not share confidential patient information on social media.

Record keeping

• Save every aftercare message, photo and reply to the patient's record, with times.
• Record who was alerted, when, and what happened next.
• The ACE Group says that when a complication occurs, records and photographs should be made at the time, and follow-up should continue until it has fully resolved.
• Save Face's standards expect a log of adverse events and complaints, and the JCCP code refers to reporting serious suspected adverse reactions to the MHRA.
• Both the JCCP and Save Face expect openness with patients when something goes wrong.

What reception should never do

This applies equally to a receptionist and to an AI front desk:

• never diagnose, or say what a symptom "probably" is;
• never reassure that something is normal or "will settle";
• never suggest medication, remedies, massage or anything to apply;
• never tell a patient to wait and see;
• never ask for photos as a substitute for a clinician speaking to the patient;
• never promise a callback time you can't keep.

The safe reply to any symptom is the same: "Thank you for letting us know. I'm passing this to [clinician] now." If anything sounds urgent, add the clinic's out-of-hours number, or 999 for an emergency.

Where a front desk helps

The FlowSmart front desk answers routine aftercare questions only from your clinic's own written information. Anything about a symptom or a concern is flagged to a clinician rather than answered. Every conversation is kept as a timestamped record, hosted in London. Your clinicians still make every clinical decision.