For owners of consultation led clinics
Every enquiry, accounted for.
Named people work every enquiry in your clinic's name, with software behind them. Nothing for your team to run.
One clinic group, one month, 412 enquiries. What each one is worth, who holds it, and what happened.
August in 412 marks
Tap a mark, or use the arrow keys to move between marks. Enter or Space opens the selected position in the record below. Press N to jump to the next open position. The selected position is described in the line under the chart.
- 351 accounted for
- including 38 treated
- 61 open
#159 · open · 15 Aug 21:40 · rhinoplasty, Manchester · £6,800 · paid searchOpen ↓Recorded
Harcourt Cosmetic Surgery
Three sites · August 2026 · open book
O123456789 O123456789 Open positions£43.1k modelled Accounted for412 of 412 enquiries
Value account · August
What the month is worth, line by line.
| Line | Value | Provenance |
|---|---|---|
| Advertising spendAd accounts, read only | £24,600 | What the platform billsSourced |
| EnquiriesEvery one in the ledger | 412£59.71 each | Vertex ledger · £59.71 = spend ÷ enquiriesCalculated |
| Attended consultationsMatched to the clinic diary | 142£173 each | Diary export 04 Sep 2026 · £173 = spend ÷ attendedVerified Calculated |
| Treated · deposits recorded38 deposits in the practice system | £38,00038 patients | Practice system, reconciledVerified |
| Unresolved commercial positionsNo recorded outcome, nobody's name against them | 61of 412 | Open, being workedOpen |
| Procedure value representedList prices of the procedures asked about | £468,45061 positions | Illustrative list pricesIllustrative |
| Modelled value in open positionsAt August's own enquiry to treatment rate, 9.2% | £43,097not lost, not recovered | £468,450 × 9.2%Modelled |
Open is open. Not lost, not recovered. The modelled figure is arithmetic on stated inputs, shown so the size of the work is visible. The only line Vertex is judged on is the one marked verified.
Open one position
One enquiry, from missed call to recorded deposit.
Key stages shown. Every step is recorded and can be opened.
Position #15915 Aug · 21:40Open
Service hour0 min
- +0 minMissed call, Saturday 21:40patient · paid searchlist price£6,800
- +0 minAcknowledged, disclosed as automaticautomationanswer givennone
- +12 minCall 1, no answer · text sentPriya Nair · deskin queue48:00 left
- +30 min“Thursday afternoon possible?”patient
- +34 minThree slots offered from the live diaryPriya Nair · approvedclaims gatepassed
- +10h 23m“I take a blood thinner, is that ok?”patient
- +10h 24mClinical question detectedautomationrouted toMiss OkaforClinician boundary · the desk writes nothing further
- +1d 10hAnswered, passed on uneditedMiss Okafor · FRCS (Plast)clinicalclinician
- +1d 10hBooked Thursday 14:00Sarah Lindqvist · clinic diaryheld bythe clinic
- +5d 12hAttendeddiary export 04 Sepevidenceverified
- +5d 13hDeposit recordedpractice systemrecorded£1,000
- List price
- £6,800Procedure asked about. Illustrative
- Modelled expected value
- £6269.2% of list, August's rate. Modelled
- Recorded outcome
- OpenNo deposit, no decline, no dated next action yet.
Commercial intelligence
Why sixty one positions stayed open this month, and what each reason is worth.
| Reason | Positions and value |
|---|---|
| No reply to the first attempt yetCalled and texted in the service hour, then daily until a dated next contact exists | 24£196.5k at list · £18.1k modelled |
| Missed the consultationCalled within six minutes of the missed time, rebooked, slot reoffered | 13£101.1k at list · £9,301 modelled |
| Quoted, then silenceFollowed up on day 3, 9 and 14, questions passed to the surgeon | 12£83.2k at list · £7,654 modelled |
| Waiting on the clinicChased twice a day until the clinic answers a price or a slot | 8£54.8k at list · £5,037 modelled |
| Clinical question with a clinicianRouted, logged, never answered by the desk | 4£32.9k at list · £3,027 modelled |
- 24of 61
- The largest open group is the cheapest to close: a first reply that never came. The desk works it in the service hour, and it carries the most modelled value of any reason.
Demand against capacity · next 4 weeks
Where more demand would pay, and where it would only queue.
Consultation slots per site against the bookings current demand will produce. Spend follows capacity, not the other way round. Manchester in full; tap the other sites.
Manchester
93% booked · next 4 weeks- 44 slots, next 4 weeks
- 41 booked · 3 open
- 24 enquiries a week
- 41 expected bookings, 4 weeks
- +38 beyond capacity
Hold spend41 expected bookings in the next 4 weeks for 3 open slots. More spend would queue, not convert. Offer Wilmslow and Leeds slots to Manchester enquiries.
- 40 slots, next 4 weeks
- 26 booked · 14 open
- 8 enquiries a week
- 14 expected bookings, 4 weeks
Hold · redirect14 expected bookings in the next 4 weeks for 14 open slots. Balanced. Take Manchester overflow before buying more.
- 36 slots, next 4 weeks
- 19 booked · 17 open
- 9 enquiries a week
- 15 expected bookings, 4 weeks
Increase spend17 open slots in the next 4 weeks, 15 expected bookings. Room for 2 more consultations at the current booking rate. Grow demand here first.
Method · next 4 weeks · slots and bookings from the clinic diary Verified · expected bookings = enquiries a week × 4 × August booking rate (176 of 412, 43%) Modelled · re run weekly from the export.
Statement of commercial activity
Harcourt
August 2026
Sixty more positions were worked over the rest of August. By the 31st, 412 of 412 accounted for.
| Line | Figure | Basis |
|---|---|---|
| Enquiries · accounted for | 412 · 412 | Vertex ledger |
| Attended consultations | 142 | Diary export 04 Sep 2026Verified |
| Deposits recorded | 38 · £38,000 | Practice system, reconciledVerified |
| Cost per attended consultation | £173 | Spend ÷ attended, both recordedCalculated |
| Recommendation, next 4 weeks | Hold Manchester Grow Leeds | Capacity method aboveModelled |
| Signed off before invoice | 8 Sep 2026 | Harcourt Cosmetic Surgery · nothing about patients sent to GoogleIllustrative |
- Verified
- reconciled to a clinic record
- Sourced
- external fact, with source
- Calculated
- arithmetic on recorded numbers
- Modelled
- arithmetic with a stated assumption
- Illustrative
- synthetic demonstration
The operating desk · Tuesday 08:14
What Vertex owns before your clinic opens.
Every open position sits in a named person's queue with a clock on it. Nothing waits without a name. Tap the first item to see what the desk would do, and who approves it.
Harcourt · deskIn the clinic's name
08:14:07TUE
9 open · by time to breachservice hour 60 min
-
Prepared for the call
Voicemail transcribed: "the nose thing, and whether you do finance". Finance is a clinic answer, so the script asks two questions and offers three slots from the live diary. No price.
Touched by
- Automation
- Vertex desk
Capabilities used
- Call analysed
- Opportunity prioritised
- Next action prepared
- Call · Priya Nair
- Reassign
Never a price, a suitability opinion or a finance offer from this desk. Anything clinical goes to a clinician.
-
Escalaterouted 08:03 A.K. · asked whether a medication rules her outclinical Miss Okafor FRCS (Plast)the desk wrote nothing else
-
No showtoday · call 09:30 L.B. · facelift · missed 14:00 yesterday£11,400 list Tom Whitfieldslot reoffered
6 more below0 breaches today
Illustrative · the queue groups, clocks and approval rules are the real operating design
Proof · how Vertex knows it was Vertex
Same clinic, same month, same advertising. Only the start date differs.
Enquiries are split into two waves before day one. One is worked from week one, the other held back two weeks, agreed in writing. Attendance is read from your diary for both.
Attended marks in green, from the diary export
Unworked weeks shown hollow · the same diary export
+9measured difference · interval +4 to +14
The effect Vertex can claim is this difference with its interval. Not the 75. Not the 142.
CalculatedInterval modelledIllustrative
| Figure | What the word means | Provenance |
|---|---|---|
| 388contacted within the hour | Recorded. What the desk did, in its own ledger. Yours to inspect line by line. | Recorded · ledger |
| 142attended | Verified. What your diary confirms in the monthly export. The only line we invoice on. | Verified |
| £43.1kin open positions | Modelled. Arithmetic with a stated assumption you can change. Never money that exists. | Modelled |
| +9against the held-back wave | Claimed. The difference between the waves, with its interval. About 300 enquiries a wave gives a usable read. | Calculated from verified counts |
Protect · governance you can see
Six levels of approval. The last one has no approver.
| Level | What it covers, and who approves it |
|---|---|
| 0 | Information onlyNo approver needed |
| 1 | Internal task: a call list, a broken tagDesk coordinator |
| 2 | Any text a patient will readClaims gate, then a named human · a draft cannot send itself |
| 3 | Spend change within an agreed thresholdAccount lead |
| 4 | Any clinical statement in any contentA named clinician, sign off recorded |
| 5 | Clinical advice to patients. Price changes. Health based ad audiences. Identifier uploads. |
Consent recorded before every contact · claims gate before anything is sent · every automated step visible to you with the name that approved it.
Around your clinic, not instead of it
Your systems stay yours.
- Reads
- Enquiries as they land, diary slots, ad spend and click ids.read only · nothing about patients sent back
- Prepares
- Replies, bookings and follow ups in your name, each approved by a named person.your coordinators keep their patients and commission
- Writes back
- Only where agreed: bookings handed to your coordinator, the statement to you and your agency.nothing replaced, nothing migrated
Starting · the Proof Sprint
Thirty to forty five days. Your own diary, reconstructed.
Six months of your enquiries rebuilt against your diary, one recovery wave run against a holdout agreed in writing, a signed statement and a go or no go.
- day1Processor agreement, diary export, read only ad accessNothing about patients moves without a recorded basis.
- day7Measurement repairedPhone links, conversion tags, consent order. 16 of 144 clinic sites we checked had a hard defect.Sourced
- day14Six months reconciledEvery enquiry: attended, declined, closed with a reason, or open with a name.
- day21Recovery wave oneHoldout agreed in writing so the effect can be measured.
- day35Wave two, capacity mapMoney gap with every assumption labelled.
- day45Signed statement, go or no goYou keep everything either way.Verified
- Fee
- Fixed, agreed before day one. Never a share of media, never a fee per patient.
- Then
- The desk follows only if the statement justifies it, with an exit right at day 90.
The next step
See what your account would say.
A Proof Sprint starts with your diary export and ends with a signed statement of what actually happened to your enquiries.
- Day one needs a diary or practice system export, weekly, CSV is fine.
- Where available, read only access to your ad accounts.
- A processor agreement, signed before anything about patients moves.
You keep the findings whatever you decide. The desk follows only if the statement justifies it. Nothing about patients goes to Google, from us or anyone.