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Its shit. The number you ring to say you can't come is the direct number for the cardiology unit, not the appointments number. So they can only cancel it. They can't rebook you are even tell anyone what dates you cannot make. They just say, you'll just go back in the hopper and you have to wait for a letter to arrive with a new date.
The system is crap. And I also blame 14 years of underfunding and deliberate mismanagement by the last government.
This feels like a mistake though (obviously?)... in my experience, if you can't make it and let them know then you get rescheduled rather than cancelled.