Guide

How to run a therapy waiting list

A next contact date, an owner, and a sentence you can say out loud about the wait. Software does not replace a crisis response.

Updated 4 October 2026.

Information, not legal advice. This page is a practical overview for practices. It is not a substitute for advice on your own contracts, insurance or registration.

A waiting list is a clinical instrument, not a spreadsheet of hope. People on it are often distressed. Some will be unsafe to leave for months with a single “we’ll be in touch”. A fair list has a purpose, a way to sort urgency, a rhythm of contact, and a point at which you say you cannot offer a place. This guide is for counselling and therapy practices in the UK and for colleagues in South Africa who run a private list. It is not a protocol for an emergency department.

Reach + Within is not a crisis service. It does not monitor emergencies. If someone may be at immediate risk, your list procedure should tell the enquirer to contact local emergency services, and you should follow your own safeguarding duty. Software will not do that for you.

Why the list exists

Write one sentence: “This list holds people we intend to offer an assessment, in this order, within this kind of wait.” If you cannot finish the sentence, you do not have a list. You have a pile. Decide whether the list is for your solo practice, a group, or a rehab’s outpatient programme. Residential admissions are a different queue, with beds and a clinical screen, and should not be mixed into the same column as weekly therapy.

Say on your website how long a typical wait is, in ranges you can defend (“about two months”, not “soon”). Update the sentence when it stops being true. An honest long wait is kinder than a cheerful one that is fiction.

Triage without theatre

You do not need a 40-item form to sort a list. You do need enough to know who cannot wait for the ordinary queue.

Ask, in the enquiry, the kind of help they want, whether they are safe tonight, and whether they are already in services. Offer a phone call for anyone who describes current risk, rather than leaving them as a row in a sheet. A practice that cannot make that call this week should say so and point to services that can, including emergency numbers and, in the UK, services such as a GP or NHS urgent mental health lines you have checked are current. Do not invent a national number on a poster you have not verified this year.

Sort the rest with criteria you publish to the team, even if you do not publish the scoring to the public. Examples that are fair if you apply them consistently: people already known to the practice returning after a planned break; people referred by a colleague with a specific risk note; everyone else by date. What is not fair is moving friends, or people who email most often, to the top without a written reason. Frequency of chasing is often a sign of distress. It can also be a sign of relative advantage. Do not let either silently rewrite the order. Record the reason if you do change it.

Contact cadence

Silence is the harm most lists cause. Pick a cadence and keep it.

• On receipt: an automatic or same-day reply that says you have the enquiry, whether you have space, and what the next step is. Do not ask them to send clinical detail to a generic inbox if you can help it.
• If the wait is longer than a month: a short note at a set interval (for example every four weeks) that confirms they are still on the list, repeats the rough wait, and tells them how to say if things have worsened.
• If they do not reply to two check-ins: a final note with a date on which you will close the enquiry, and how to reapply.
• When you offer a place: a clear hold (“reply by Friday”) so you are not blocking a slot for someone who has found another therapist.

The PA can send these messages. They should not read the clinical story in order to do it. A template with the person’s name, the date they enquired, and the next step is enough. Group practices fall over when the cadence lives in one owner’s head.

Keeping people safe while they wait

At each check-in, one line is enough: “If you are in immediate danger, contact emergency services. If your situation has worsened, reply to this message and we will review the wait.” Mean the second sentence. A review might mean an earlier assessment, or it might mean telling them you still cannot see them and naming somewhere that can. Both are more honest than silence.

Do not offer a holding session you cannot clinically support. A single unstructured call that opens trauma and then returns the person to a three-month wait can be worse than a clear boundary. If you do offer a brief check-in, say what it is and what it is not.

For practices that work with families of people in residential programmes, the waiting question is different: the family wants news, and the client controls what may be shared. Use an agreed report, not a running commentary. The rehabs page describes family reports as a quote conversation, not as a public price.

Closing the list, and the record

A waiting-list entry is personal data. Keep it only as long as you need it for the purpose you stated. When someone starts therapy, the enquiry becomes part of the clinical record and follows your retention rule. When someone never starts, delete or minimise on the schedule in your notice. The guides on UK GDPR and how long to keep records are the place for that decision. Do not keep a decade of unanswered enquiries “just in case”.

Write the outcome on the card: offered and accepted, offered and declined, closed after no reply, signposted because of risk, or removed at their request. Future you will not remember. A complaint about a wait is answered with that line, not with a feeling that you are a caring person.

What software should do here

The list should show an owner, a next contact date, and a status. It should not require the clinician to retype the phone number into a diary later. Reach takes the enquiry from a form, with consent to store the message, and hands off to the clinical file when you onboard. That is the path in the demo and on the therapists page. If your current tool cannot show “next contact” without a private colour code only you understand, the list is already unsafe on a week you are ill.

Fairness is mostly a policy. Software only helps if the policy is visible to the whole team and the dates are real.