Patient access consulting: turn the demand you already have into care you actually deliver.
Growth spend brings people to the front door. Patient access determines how many of them get through it. For most providers the largest available gain is not more enquiries — it is a front door that converts, schedules and retains without stranding clinical capacity.
Built from running access at scale
Clarendum is led by Ian McPhee, who built and scaled a patient access organisation of more than 150 people and led operations across a national network of 236 clinics and telehealth services at Optum Behavioural Care, part of United Health Group. That is the vantage point this work comes from: access designed as a revenue-bearing operating function with owners, targets and quality standards, not a mailbox and a phone line.
What we work on
Enquiry-to-booking conversion
Every enquiry that arrives and does not become an appointment is demand you have already paid for. We follow real enquiries through the pathway — response times, contact attempts, information asked for too early, handoffs that stall — and rebuild the sequence so the majority convert rather than the minority.
Intake and triage design
Triage decides who gets seen, by whom and how quickly. Poorly designed intake either over-assesses low-complexity patients or pushes complexity to the wrong clinician. We design triage around clinical appropriateness and throughput together, so senior clinical time is spent where it changes outcomes.
Capacity, utilisation and demand matching
Most providers do not have a capacity problem in aggregate; they have a matching problem in detail. Slot types, rota shape, session length and booking rules routinely leave usable capacity stranded. We model demand against real available capacity and reshape the booking rules that create the mismatch.
Cancellations, no-shows and rebooking
Non-attendance is treated as a fact of life far more often than it needs to be. Reminder design, confirmation steps, waiting-list pull-forward and same-day backfill are operational levers with a direct revenue and access effect, and they are cheap relative to adding clinicians.
CRM and EHR workflow
We map how the workflow is genuinely performed, not how it was designed, then decide what the system should enforce, prompt or record. The aim is a pathway where the correct next action is the easiest one for the team to take.
Metrics, ownership and scalable operations
A small set of service-level measures, each with a named owner and a review cadence: conversion, time to first appointment, attendance, utilisation and contact abandonment. Beyond reporting, we build the access function itself — roles, scripts, escalation, training and quality assurance — so it holds as volume grows.
Where the capacity you are missing usually hides
Before adding clinicians or opening sites, it is worth establishing how much throughput the current structure could carry if the pathway worked. In practice, unbooked usable slots, avoidable non-attendance, over-long assessment steps and re-work at intake account for a meaningful share of apparent capacity shortfall. Releasing that first improves any subsequent growth or expansion case, because the model being replicated is one that works. I have set out the diagnostic in healthcare capacity is usually a matching problem.
If expansion is the wider question, US market entry and build vs buy cover how access performance feeds those decisions.
How engagements usually run
Access work commonly begins with a short diagnostic: pathway walkthrough, data review and a prioritised list of interventions ranked by effort against effect. From there it either becomes a redesign project or ongoing fractional support while the changes land. Formats and indicative ranges are set out on the engagements page.
Frequently asked questions
- What is patient access optimisation?
- It is the work of making sure the demand a service already has converts into booked, attended and retained care. That spans enquiry handling, referral triage, eligibility checks, scheduling, reminders, cancellation and no-show management, and the capacity model those steps draw on. Done properly it raises revenue without raising acquisition spend.
- How do I know whether patient access is my bottleneck?
- Three signals usually settle it: enquiries or referrals are growing faster than booked first appointments; clinicians report gaps in diaries while the waiting list grows; or the time from first contact to first appointment has drifted and nobody owns the number. If you cannot state your enquiry-to-first-appointment conversion rate from memory, that is a fourth.
- Which metrics should a patient access function be run on?
- At minimum: enquiry-to-booking conversion, time from first contact to first appointment, first-appointment attendance rate, clinician utilisation against available capacity, cancellation and rebooking rates, and abandonment on inbound contact routes. The point is not the dashboard; it is that one named person owns each number.
- Do you replace our CRM or EHR?
- No. Most access problems are process and ownership problems that the system then encodes. We map the workflow as it is actually performed, redesign it, and only then decide what needs to change in the CRM or EHR configuration. Replacing a system before fixing a pathway usually reproduces the pathway.
- How quickly do changes show up?
- Sequencing and follow-up changes at the front door typically show in booking and attendance data within weeks, because they act on demand that is already arriving. Capacity and rota redesign works on a longer cycle, usually a quarter or more, because it depends on clinician scheduling patterns.
Losing patients between enquiry and appointment?
A short call is usually enough to locate where the leakage sits and what the first two fixes should be.