The Executive Scorecard: 7 Numbers Every Private Psychiatry & ADHD Owner Needs

What an empty psychiatrist hour costs

A psychiatrist’s diary is the most expensive stock a private clinic holds, and it expires at the end of every clinic day. An hour nobody booked on Tuesday cannot be sold again on Thursday.

Take a clinic where one consultant psychiatrist offers 30 clinical hours a week. Across the clinics we work with, the target is £280 to £350 for every clinical hour delivered, with at least 82% of available hours booked. At 82%, that psychiatrist delivers 24.6 hours a week.

Now say the diary runs at 70%. That is 21 hours, so 3.6 hours a week sit empty. At £280 to £350 an hour, the clinic never invoices £1,008 to £1,260 a week, which comes to roughly £4,370 to £5,460 a month.

None of that loss appears in a Google Ads report. The same account can show a falling cost per lead in the same month, because nothing in the account knows which leads filled Tuesday’s clinic.

Each point of utilisation on that diary is worth 0.3 hours, or £84 to £105 a week. Scan clinics run the same arithmetic on machine hours, as we showed in The Mid-Week Scanner Deficit. In psychiatry the idle asset is a clinician’s time, and it is paid for whether or not anyone sits in the chair.

No-shows draw on the same stock. On 20 booked assessments a month, the gap between the 91% attendance our Growth Index funnel plans for and a 95% target with a deposit is 0.8 assessments, about £760 of fee a month at the £950 median, from a slot the clinician was already paid to keep free.

Why agency reports miss the numbers that run a clinic

Most Google Ads reports stop where the clinic’s money starts. They are built from what the ad platform can see, and the platform cannot see the diary.

The first gap is the conversion itself. Google Ads uses primary conversion actions both to report results and to steer bidding, so when a form submission is the primary conversion, Smart Bidding learns to buy more form submissions. In an ADHD account the cheapest form is often the one a Right to Choose shopper completes in thirty seconds.

Calls carry the same flaw. A call from an ad counts as a conversion once it passes a minimum length the account sets, so a four-minute call that ends with “is this on the NHS?” scores the same as one that ends with a deposit taken.

The platform does offer a way back. Offline conversion imports let a clinic send booked and attended outcomes from its booking system to the click or call that produced them. Without that link, cost per qualified assessment is an estimate made by somebody who has never opened the diary.

A generalist agency is not hiding anything here. It reports what the account was set up to measure, and in a psychiatry clinic that is the stage of the funnel furthest from revenue. We covered what that blindness costs at the lead stage in Why 70% of your ADHD leads never book an assessment.

How UpMedico builds the seven-number scorecard

UpMedico starts the scorecard from the diary, not from the ad account. Every number has to be readable by an owner in under a minute and has to come from a system the clinic already runs: the booking system, the call tracking platform, or an ads account linked to both.

The seven targets below are the ones we hold private psychiatry and ADHD clinics to across the UK accounts we manage. Each one answers a different question, and none of them can be read off a cost per lead report.

None of the seven is a click metric. Clicks, impressions and cost per lead still matter to the people optimising the account. The scorecard is for the person who signs off the budget and the clinician rota.

Two of the definitions do most of the work. Cost per qualified assessment counts only enquiries that passed triage and booked, which is why a clinic can halve its cost per lead and watch CPQA rise.

Triage pass rate is the early warning. Every enquiry filtered on the call rather than on the form still absorbs about 18 minutes of coordinator time, roughly £4 of wages at the 2026/27 band 3 rate. When the pass rate falls below 32%, more of the budget is paying for enquiries the clinic will filter out, and CPQA rises once they have worked through intake.

Psychiatry clinic KPI targets at a glance

The table is the scorecard itself, laid out so it can be printed or rebuilt in a sheet. Each target carries its source, because a benchmark without one is an opinion.

Read utilisation against cost per qualified assessment before anything else. A clinic with a healthy CPQA and a diary at 70% has a budget problem, not a campaign problem: the account is buying assessments at the right price and simply not buying enough of them.

The reverse case is the expensive one. A CPQA above £380 with a full diary means the clinic is paying for volume it did not need, and the triage pass rate shows where the waste enters. On a £950 assessment, a £380 CPQA leaves £570 to pay for the psychiatrist, the room and the report.

Which number to read first each week

An owner who reads all seven numbers once a month will react to the wrong one. The numbers move at different speeds, so they belong in different meetings.

Missed call rate and call-to-booking rate move daily and belong in the weekly review, broken down by hour where the call tracking allows it. A missed call rate that jumps on Monday mornings is a rota problem, and no change to the budget will touch it.

Cost per qualified assessment needs a full intake cycle before it settles, because assessments are often booked several weeks after the first click. Read it monthly, and never on a single week of data.

Revenue per clinical hour is the tiebreaker. If utilisation sits above 82% and revenue per hour below £280, the diary is full of the wrong appointments, and the fix lies in the clinic’s appointment mix rather than in Google Ads.

Utilisation and revenue per clinical hour are the owner’s numbers. They decide where the next pound goes: into Google Ads, into a second clinician’s sessions, or into the reception team. Triage pass rate and no-show rate sit between the two and tell you whether a problem lives in marketing or in operations.

A sudden fall in calls on a steady budget deserves a check for ad disapprovals before anyone blames reception; the policy side is covered in our Google Ads compliance guide for ADHD clinics. And if your agency cannot produce four of these seven numbers, the questions to put to it in writing are in our comparison of Google Ads agencies for ADHD and psychiatry clinics.

The two numbers that live on the phone

In our call tracking data, 58% of ADHD enquiries in London and 47% in regional UK arrive by phone. Roughly half of a psychiatry clinic’s scorecard is decided in conversations nobody in management hears.

Call-to-booking rate is low in this specialty for a reason. Every caller from an ad sits in the denominator, and on our accounts 65% of enquiries come from people who will find the free Right to Choose route before they pay. A clinic starting at 24% is not failing. It is answering a lot of people who were never going to book.

Missed calls are the cheaper fix. Out of 100 calls from ads, a 20% missed rate leaves 20 people unheard; if they would have booked at the same 24% as answered callers, that is close to five assessments, or about £4,560 at the £950 median fee. Bringing the rate to 4% puts 16 of those calls back in front of the reception team.

Read that rate by hour, never as a monthly average. In the scan clinics we manage, 15% to 20% of calls go unanswered between 9:00 and 11:30, with peaks of 24%, and only the hour-by-hour view exposes a gap like that. The same check belongs on a psychiatry clinic’s Monday morning.

The framework’s claim is narrower than the scorecard target. Up to 20% better call-to-booking conversion within 90 days takes a clinic from 24% to about 29%, so read 31% to 35% as the level the scorecard holds a clinic to over time, and the first quarter as the first step towards it.

The recordings explain the gap between the two numbers. Each call is scored against the clinic’s intake script, with the keyword that produced it alongside: whether the caller heard the fee, whether the Right to Choose question got a straight answer, and whether a slot was offered before goodbye. The wording your team can adapt is in our clinic phone script.

Recording these calls means processing data concerning health, which is special category data under UK GDPR. It is configured accordingly: a consent message before the call connects, a defined retention period, and access limited to the people who need it. Our note on call tracking for clinics covers the setup.

Frequently asked questions