The ‘chilling issue’ of Ghost Clinics

It may sound like a strange term, but ghost clinics or recently relabelled maxi clinics, are a practice used in the Optical Sector (high street opticians) where companies effectively double book patients to clinics to mitigate potential lost appointments if customers don’t turn up.

These extra appointments have no additional time allocated to them, but the additional patients booked in are still expected to be examined.  The bookings are called ghost clinics as although the patient is given an appointment time, they are not allocated any time to be examined.  Instead, they are expected to be “squeezed” into a regular diary, compromising the safety of the patient and the practitioner.

From a business perspective this has a positive benefit to mitigate lost revenue and improve customer satisfaction for the additional patients being added to the clinic.  In reality it creates an entirely different situation for the practitioners and the quality of service provided to the customers/patients.

So how come you’ve not heard about it?  One of the main challenges for those working in the sector is that they can’t raise certain issues for risk of bringing the profession into disrepute.  Raising issues like these may be seen as breaching standards within the profession leading them to potentially lose their registered status.  Ultimately this could result in them not being able to continue to work and effectively having to leave the profession.

The standards are governed by the General Optical Council who oversee the register for all clinicians working in the sector and to ensure public safety.  The practice of operating ghost clinics though is clearly driven by the employer.  What this creates is a greater number of appointments than capacity allows unless the extra patients turn up exactly at the same time as another patient fails to attend. If two patients turn up at the same time, then there is no flexibility or contingency. This ultimately puts pressure on the Optometrist to see patients in a rushed fashion and/or reduce examination times.

Imagine this scenario for every single patient booked in for a whole day, from both the point of view of the optometrist and the patient. The optometrist has a legal and clinical responsibility to examine each patient as thoroughly as their skills enable. The patient has an equal expectation not to be rushed through an examination.

Current examination times tend to be 25 mins per patient, so to have a 10-minute delay or to fit in another patient is very difficult.  This can lead to poor quality or rushed examinations, practitioners having to give up parts of rest break or working longer hours than contracted including increased levels of stress for the practitioner, let alone the potential safety risk to patients. None of this is good practice from a wellbeing, patient safety or employment perspective.

You could ask why the practitioner doesn’t cancel the clinic or refuse to see the patient?  Clinic diaries in your high street opticians are not usually managed by the practitioner and in fact some employers don’t allow practitioners to change the diary at all.  There have been cases where optometrists who have booked a patient in the clinic diary to create extra time are sanctioned for doing so.  In many stores there may be a mix of employed optometrists and self-employed optometrists (locums). Locums often don’t feel they can challenge the employer for fear that their contract may be terminated. This is a big issue where the sector is dominated by a small number of large operators leaving locums with few options to find alternative work.

New starters and newly qualified also feel trapped and unable to voice their concerns and in some cases are subject to threatening behaviour by managers.

Justification for ghost clinics is often based on a company’s ‘failure to attend rate’.  Prospects experience through our members indicates that only a minority of practices have high non-attendance rates, but employers still apply a blanket policy across all stores.   The premise that seeing extra patients utilises the Optometrist’s time more efficiently is a flawed concept.  Those working in the sector are fully aware that no two individuals (patients or practitioners) are the same. Therefore, there is no such thing as an average patient interaction.

In an ideal world, each appointment would be long enough to satisfy the needs of both the patient and practitioner. Patients are booked in for appointments at fixed time intervals, accepting that some will take longer than the allotted time, but some will take less. Throughout the day the longer and shorter examination times will balance themselves out allowing the smooth running of a clinic.

Prospect believe the GOC needs to investigate this practice based on its overarching requirement to protect the public. A definitive stance to the sector on ghost clinics needs to be made.

There will always be the need for a balance between the retail and clinical sides of a business, but Prospect believe the use of ghost clinics crosses the line and is a practice that must stop.

We are seeking support from the public, as well as all eye care practitioners to eradicate ghost clinics from optometry all together.

A question to ask yourself is whether you would be happy to be rushed through your eye examination or have it delayed so the optical outlet can gain another spectacle or contact lens purchase from someone else? Help show your support by signing our petition.

Prospect will continue to support our members where this practice is being applied and notify employers that they are putting their employees in a position which may breach their and the employers requirements under the GOC Standards to ensure that any operational or commercial targets do not have an adverse effect on patient care and that sufficient time, so far as possible is allowed, to accommodate patients’ individual needs within the provision of care.