Atlacare
Revenue is a lagging indicator. By the time it drops, the cause happened three months ago. The six numbers below are the inputs that produce it, and each one has a lever attached that you can pull this week. There is a scorecard at the end.
Most private practices track one number. It is the wrong one to manage by, because it tells you what already happened rather than what is about to.
Why six?
Because these are the things that actually move income in a practice, in rough order of how much they matter.
| # | Number | Weight | UK benchmark |
|---|---|---|---|
| 1 | Retention, meaning rebooking rate | 30% | 73.3% average, 84.8% top decile |
| 2 | Revenue health, meaning collection | 22% | No reliable UK benchmark |
| 3 | Diary utilisation | 18% | 72.3% average |
| 4 | Attendance | 13% | DNA 6.3 to 8%, cancellations 9 to 10% |
| 5 | Clinical outcomes | 12% | No cross-discipline benchmark |
| 6 | Growth | 5% | Varies by stage |
The weights are the ones Atlacare uses to compute its Practice Health Score, and they are deliberate. Retention carries the most because it is the cheapest income in the business. Growth carries the least because chasing new patients while leaking existing ones is the most expensive way to stand still.
Benchmarks are from the Private Practice Barometer 2026, a self-reported survey of 715 UK clinic owners.
1. Retention, at 30%
What it is: the share of patients seen who book another appointment.
How to calculate: of patients seen in the last 60 days, what proportion has a future appointment booked or has been formally discharged. Discharge is a success, not a loss, and counting it as churn will mislead you badly.
Benchmark: UK physiotherapy averages 73.3%, and the top 10% reach 84.8%.
Why it carries the most weight: a rebooked patient costs nothing to acquire. Median acquisition cost is £25, so every point of retention is a patient you did not have to buy. Raising rebooking by ten points does more for income than almost anything else available to you.
The lever: book the next appointment in the room, before they leave. The gap between average and top decile is almost entirely this, and not charisma.
The trap: counting completed episodes as failures. Set a rule for what discharge means and apply it consistently, or the number is noise.
2. Revenue health, at 22%
What it is: whether the work you did turns into money in the account.
How to calculate: invoiced versus collected over 90 days, plus the total sitting overdue.
Benchmark: we could not find a reliable UK benchmark for allied health collection rates, so treat any figure you are offered with suspicion, including ours. What we can say is that the gap between invoiced and collected should be small and stable, and that a growing overdue balance is a problem long before it is a crisis.
Why it matters: this is the number that makes a busy practice insolvent. You can be fully booked, well reviewed and clinically excellent while quietly funding your patients' treatment.
The lever: take payment at the point of care wherever you can. The second lever is a routine for chasing at 30 days that does not depend on you feeling like doing it.
The trap: insurer work. Authorisations expire, sessions get delivered beyond what was approved, and nobody pays for them. Track sessions authorised against sessions used before you book the next one.
3. Diary utilisation, at 18%
What it is: delivered appointments as a share of bookable slots.
Benchmark: 72.3% average. Above 80%, waiting times rise from 2.6 days to 5.5 days and you start losing enquiries you never see.
Why it is not simply "higher is better": this is the number people most often misunderstand. The target is the high seventies with slack placed deliberately, not the nineties. Our guide to diary utilisation works through why.
The lever: measure delivered rather than booked. Roughly one in six booked appointments evaporates, so the two numbers are not close.
The trap: measuring hours at work instead of slots you would genuinely sell.
4. Attendance, at 13%
What it is: the share of booked appointments that happen.
Benchmark: DNA runs 7 to 8% without reminders and 6.3% with. Cancellations add a further 9 to 10%.
Why it is separate from utilisation: because the fixes are different. Utilisation is a booking problem. Attendance is a commitment problem.
The lever: reminder wording. Trial evidence has reminders naming the cost of a missed appointment cutting DNA from 11.1% to 8.4%, a relative reduction of about a quarter. Vague wording performs materially worse. Our no-show guide covers the evidence.
The trap: treating cancellations and no-shows as the same event. A cancellation can be refilled. A no-show cannot. Making cancellation easier looks like surrender and is not.
5. Clinical outcomes, at 12%
What it is: the share of patients showing meaningful improvement on whatever measure fits your work.
Benchmark: none that transfers across disciplines, and be sceptical of anyone offering one.
Why it is on a business list: three reasons. It is the honest answer to whether the practice is any good. It is what insurers increasingly ask for. And it is what turns a discharge conversation into a rebooking conversation, because a patient who can see their own progress understands why there is one more session.
The lever: pick one measure per presentation and use it at first appointment, midpoint and discharge. Three data points beat a form nobody fills in.
The trap: collecting outcome data and never looking at it, which is common and is worse than not collecting it, because it costs the patient time and tells you nothing.
6. Growth, at 5%
What it is: new patients per month, and the direction of travel.
Why the weight is so low: because it is the number practices obsess over while ignoring the five above. A practice retaining at 85% grows on its own. A practice retaining at 60% cannot buy its way out, and every new patient is poured into a leaking bucket.
The lever: if the other five are healthy, growth is a marketing question. If they are not, growth is a distraction.
The trap: judging a month in isolation. Look at three-month trend or you will be reacting to noise.
What these look like in each discipline
The six are universal. What counts as good is not.
Physiotherapy, osteopathy and chiropractic
The benchmarks above fit directly. Watch sessions per episode of care alongside them: median is 5.0, top decile 8 or more, and three extra sessions at £63 is £189 per patient with no acquisition cost. Handle it as better discharge planning rather than as selling more appointments.
Podiatry
Retention behaves differently, because routine care recurs on a six to ten week cycle. Your retention number should really be cycle adherence: what share of routine patients attended within their interval.
Utilisation for domiciliary work should be measured in minutes of day consumed rather than slots. See pricing a domiciliary round.
Counselling, psychotherapy and psychology
Two of the six need rewriting here.
Retention is not rebooking. Therapy runs on a standing weekly slot, so the meaningful figures are average episode length and how quickly an ended contract is refilled.
Utilisation should be capped deliberately. A therapist at 100% clinical hours has no room for notes, supervision or the weight of the work. Treat the gap as a requirement rather than a loss.
Attendance is usually stronger than in physical therapies, because a held slot and a clear policy do most of the work.
Speech and language therapy
Everything is term-shaped. An annual utilisation figure is meaningless. Measure term-time separately and plan the holidays as a different offering rather than as dead time.
Outcomes carry more weight than the 12% here, because EHCP and tribunal work depends on documented, quantified progress. See notes as tribunal evidence.
Occupational therapy
Travel distorts utilisation badly. Measure minutes of day per appointment. Revenue health deserves more attention than the 22% suggests, because report and case-management work is invoiced in larger, less frequent amounts, which makes a single late payment material.
Massage therapy
Utilisation should be capped at what your body sustains, not maximised. The ceiling is physical.
Retention is the number that matters most, because there is rarely a clinical interval to fall back on, and rebooking in the room is effectively the whole business model.
Dietetics and nutrition
Retention is best measured as programme completion rather than rebooking, since the work is naturally block-shaped. Attendance tends to drop sharply after the initial consultation, so measure it by appointment number, not as an average.
The scorecard
Ten questions. Score each 0, 1 or 2. Total out of 20.
| Question | 0 | 1 | 2 | |
|---|---|---|---|---|
| 1 | Do you know your rebooking rate? | No | Roughly | To the point |
| 2 | Is it above 75%? | Below 65% | 65 to 75% | Above 75% |
| 3 | Do you know what is overdue right now? | No | Roughly | Exactly |
| 4 | Do most patients pay at the point of care? | Rarely | Sometimes | Usually |
| 5 | Do you know your delivered utilisation? | No | Booked only | Delivered |
| 6 | Is your new patient wait under three days? | Over a week | 3 to 7 days | Under 3 days |
| 7 | Do your reminders name the cost of a missed appointment? | No reminders | Generic | Names the cost |
| 8 | Do you use an outcome measure at first and last visit? | No | Sometimes | Routinely |
| 9 | Is your next appointment booked before the patient leaves? | Rarely | Sometimes | Routinely |
| 10 | Do you look at these monthly? | Never | Occasionally | Monthly |
16 to 20. You are running a business, not just a caseload. The remaining gains are in pricing and service mix. See which add-on services actually pay.
10 to 15. Normal, and there is real money in the gaps. Fix questions 9 and 7 first. They are the cheapest points on the board.
5 to 9. The practice is running you. Start with one number, rebooking, for one month. Do not try to fix all six.
Under 5. Nothing is being measured, which is not a moral failing and is very common. Pick question 9 and do only that until it is routine.
Where to get the numbers
Most of these come out of your appointment and invoicing data, if the system will give them to you. Some practices build a monthly spreadsheet, which works and takes about an hour a month.
Atlacare computes all six as Clinic Health, with one honest design detail worth knowing: dimensions it cannot measure are excluded and the remaining weights re-normalised, so a new practice with no outcome data is not scored down for it. A score that quietly penalises you for data you have not collected yet is worse than no score.
Whatever you use, the discipline matters more than the tool. One number, looked at monthly, beats six you gather once and never revisit.
Benchmarks are from a self-reported survey of 715 UK clinic owners and from published trial evidence, not from audited accounts. No reliable UK benchmark exists for collection rates or cross-discipline clinical outcomes, and none is offered here. The weights described are those used in Atlacare's Practice Health Score and are a judgement about what matters, not an industry standard.
Sources: UK Private Practice Barometer 2026
Related: What is a good diary utilisation rate? · How do you win back lapsed patients? · Which add-on services actually pay?