Cliniko for UK clinics: the admin jobs it does well, and the ones it does not

Cliniko handles the parts of clinic admin that follow a rule, and it leaves you the parts that need a decision. It will send the reminder, build the list and flag the unpaid invoice. It will not choose who to chase, write the letter, or notice that an insurer has settled six pounds under your fee.

I have spent most of eleven years working inside practice software, and Cliniko is the one I know best. This is an honest account of where that line falls, because clinic owners often reach for a change of system when what they actually have is a shortage of hours.

The short version

• Cliniko automates anything rule based: confirmations, reminders, cancellation emails.
• Its reports find the problems. A person still has to act on them.
• Recalls produce a list, not a message. Cliniko sends nothing itself.
• UK insurer billing mostly happens outside Cliniko, or through a connected app.
• A software gap is usually an admin hours gap.

What Cliniko does on its own

Once you link a message template to an appointment type, the automatic messages go out without anyone touching them. Confirmations go by email a couple of minutes after a booking is made, and reminders go by email or SMS ahead of the appointment. Cliniko's overview of reminders and confirmations sets out the conditions: the patient needs contact details on file, they must not have turned those messages off, and SMS needs credits in the account.

Cancellation emails work the same way. They go out as soon as an appointment is cancelled, whoever cancelled it, and Cliniko's notes on cancellation emails point out there is no SMS version of that one.

This is the half of the job software is genuinely good at. If a rule can be written down, Cliniko will follow it every time, at three in the morning, without getting distracted. Where clinics lose the benefit is not the sending, it is the data underneath it. A patient record with no mobile number gets no text reminder, and nobody finds that out until the patient does not arrive.

The reports that find problems without solving them

There are two reports worth opening every week. The outstanding invoices report lists every invoice still marked open, with the patient and practitioner attached, and lets you email or print straight from that screen. The uninvoiced appointments report lists appointments that have no invoice linked to them.

The second one carries a limitation worth knowing about. Cliniko's documentation is explicit that an appointment only appears there if no invoices have been created whatsoever. An appointment billed to the wrong payer, or billed for the wrong amount, has an invoice attached to it, so it is not missing, and the report stays quiet. Those are usually the ones that cost you, and they get found by reading, not by filtering.

Both reports do the finding. Neither does the chasing. The distance between a list of open invoices and money in the account is somebody sitting down on a Tuesday and working through it, and that is time rather than software.

Recalls: a list is not a message

Recalls are the clearest example of where the line sits. You can set up recall types for follow-ups and anniversaries, and Cliniko will hold them against the right patients. Then you run the report, and what comes back is a list of names and mobile numbers.

Cliniko's guide to setting up recalls describes the next step plainly: once the report is generated you begin the follow-up, and follow-up could include sending a letter or calling the patient. You then tick a box against each name to mark them as recalled. Nothing goes out by itself.

I think that is the right design. A recall is a judgement about one particular patient, and a blanket automatic message would be worse than nothing. It does mean the feature only works in a clinic where somebody owns the list, and in a lot of small practices nobody does. The report quietly grows, and the patients who stopped coming stay stopped.

Where UK clinics reach the edge of the software

Insurer billing is where the edges of any general practice management system show, because the UK process is its own animal. You can address an invoice to a third party rather than the patient. Cliniko's article on third party invoices explains that you add an email address under the patient's billing information, and invoices and receipts then go there instead.

That covers producing the document and sending it. It does not cover the process wrapped around it: submitting by the route the insurer accepts, matching remittances back against the right invoices, and picking up the differences. Most UK clinics handle that either in the insurer's own provider portal or through a clearing service such as Healthcode, which validates invoices against insurer requirements before they are submitted.

There is also a connected app aimed at exactly this. Effra appears in Cliniko's app directory and says it bills major UK insurers without leaving Cliniko and processes remittances automatically. I have not run a clinic on it, so take that as a pointer rather than a recommendation. Whichever route you use, the reconciliation still needs somebody to read it, which is a separate job I have written about in chasing insurer shortfalls.

The jobs no practice software will do

Every system has this list and it is longer than people expect. Writing the GP letter is on it. So is deciding whether a balance is worth chasing or worth writing off, ringing the patient whose card was declined, and reading a remittance to work out which of four invoices a single payment actually covers.

The other UK systems I work in, PPS and TM3 and WriteUpp and Semble, divide along the same line. The menus are different and the boundary is not. None of that is a criticism of any of them. These are record keeping and scheduling tools that also send messages, and they were never going to make the awkward phone call for you.

So do you need different software?

Usually not. When a clinic owner tells me the system is the problem, the honest answer is often that the system is fine and nobody has the hours to use the half of it that needs a person. Migrating costs more than it looks like on the quote, because your history, your templates and your habits all have to come with you.

The test I would apply is a plain one. Write down the admin jobs that are actually going wrong, then mark each as either "the software cannot do this" or "nobody has done this". If most of your marks land in the first column, go and look at other systems properly. If most land in the second, a new system will hand you the same backlog behind an unfamiliar menu.

For the second column the fix is hours, not migration. There is more about how that works day to day on the Cliniko page.