A course of treatment is one decision and a dozen appointments

A series is not a slot repeated

Booking software is built around the single appointment, and a course gets represented as several unrelated ones. That representation is the problem: nothing in the system knows that missing the fourth matters more than missing a first consultation, that the gap between sessions has a clinical intent, or that the patient still owes four. Before adding any assistant, decide where the course itself lives as an object - because an assistant can only report what the clinic already tracks.

The miss in the middle costs more than the miss at the start

A patient who never attends a first appointment has cost a slot. A patient who stops after session three has cost a slot, the benefit of the first three sessions, and usually the outcome the course existed to produce. Those two events look identical in most reporting. Separating them is worth doing before anything is automated, because it changes which patient the practice chases and how soon.

Who owns the gap when the clinician is away

Courses break on leave. The physiotherapist is away for two weeks and six patients mid-course need rearranging around a gap that has a clinical meaning - some can wait, some should see a colleague, some need the interval preserved. That triage belongs to the clinician. What can be handed to an assistant is the part after the decision: telling each patient what is happening, in their language, and collecting when they can come.

What the assistant may move, and what it must not

Moving one session within a week the clinic has already marked as flexible is administration. Shortening an interval, extending a course, substituting a clinician or cancelling a remaining block is not, whatever the patient's reason. The useful design states this as a rule the patient can see: here is what I can change now, here is what I will pass to the clinic, and here is when you will hear back.