Commercial practices, patient safety, and ghost clinics

We regularly hear concerns about commercial practices impacting on patient care in the eye care sector and this has been backed up by the findings of our 2025 registrant survey. Among other findings, 38% of registrants who responded felt pressured to see a high volume of patients every day, impacting their ability to deliver safe care. For this reason, we have decided to carry out a thematic review or deep dive on the topic of commercial practices and patient safety. 

One of the issues we are investigating is so-called ‘ghost clinics’. This term can mean different things to different people and happens to differing degrees. But, in essence, it is a clinic of patients for which no optometrist is allocated, requiring those working that day to cover these additional patients on top of their allocated bookings.  

We’re told this is not an unusual business practice and happens most often at practices where patients regularly do not turn up for their appointments (referred to as a ‘DNA rate’ or failure to attend). Making such additional bookings could benefit patients who might otherwise not be seen, as well as maximise revenue for the business. But the concern is that ghost clinics could result in rushed or reduced appointment times, impacting on both patient safety and registrant wellbeing. 

The Association of Optometrists’ (AOP) guidance on ghost clinics advises practice owners/managers that it is not acceptable to expect clinicians to work through their lunch break or work longer hours to see additional patients. They also advise clinicians to be prepared to refuse to see patients if it is outside their standard working hours. 

As part of our thematic review into commercial practices and patient safety, we want to understand more about the nature and extent of overbooking / ghost clinics. We’d like to know: How often is it happening? What are the impacts on you and your patients? Have you ever raised any concerns about it with your employer, and, if so, what was your experience?  

You can give us your views either in response to our post on LinkedIn, or through this short survey. 

At the end of our thematic review, we will produce a report with recommendations to address the issues identified. This is an opportunity to have your say and be part of our research.