AOP statement on 'ghost clinics'

Our updated advice on ghost clinics

We would like to clear up a misunderstanding and correct some inaccurate claims that have been levelled at the AOP about our position on 'ghost clinics'. This centres around the phrase "good business sense" and more generally on our position on the use of ghost clinics or additional appointments. 

  • Firstly, when we said it "may make good business sense" that was in no way an endorsement of the practice, but instead an acknowledgement of a fact. From a purely business perspective it does make sense to ensure the clinic is busy and safely sees as many patients as possible, however that is not the same as saying it is acceptable
  • Secondly, when we have said that booking some additional appointments when there is a high no-show rate can be ok, that was based upon a general presumption that businesses could be trusted to act in an appropriate and responsible manner. This would include having a process to handle a situation where all patients attend, and being prepared to explain to patients that they cannot be seen

Sadly, we have now been provided with evidence that at least one large chain is applying a blanket policy of mandating that ghost clinics must be in use, regardless of the historic no-show rate or appointment availability in a particular practice. Clearly this isn't acceptable and as such we believe that it is necessary to refine our advice to remove any ambiguity. 

Advice for practice owners/managers 

  • Ghost clinics should not be run as standard or default practice
  • You should not expect clinicians to miss all or part of their breaks or lunch, or work longer hours, to see additional patients
  • You should under no circumstances book more patients into unstaffed slots than the historic no show rate in the particular practice
  • You should be prepared to rebook ghost clinic patients if all standard clinic patients attend

Advice for employees and locums

  • Be prepared to refuse to see additional patients outside your standard working hours if there is not a free appointment slot during those hours
  • Be prepared to remind practices that booking additional patients where there is not capacity may place them in breach of GOC Standards:
    • 1.1.10 Ensures that any operational or commercial targets do not have an adverse effect on patient care. 
    • 3.1.4 Allows staff sufficient time, so far as possible, to accommodate patients' individual needs within the provision of care.

If practices owners/managers do not take appropriate steps to rectify the issue, then members should contact us and we will support them to raise the issue with the practice and if necessary, help them to take the matter further. 

To reiterate, it is not in any way acceptable to expect clinicians to not get the breaks that they are entitled to, work additional unpaid hours, or to work at an unsafe speed. This is even more important with the additional pressures that the pandemic brings.