BUPA Puts Pressure on Physiotherapy

BUPA’s introduction of its recent tender process has caused anger and grave concern amongst private physiotherapists. BUPA is the largest private medical insurer in the UK and has been reviewing orthopaedic services recently, now moving on to the reported inequalities in private physiotherapy services. BUPA’s intentions are stated to be to look at the alleged inequalities in quality, cost and customer service in physiotherapy provision across the country. Six thousand physiotherapists have been effectively requested to enter a price competition to be allocated BUPA patients.

BUPA has asked physiotherapists and practices to complete the online tender process by Friday 24th April, covering information about customer services, quality, the practice and the base prices they can offer. Only if approved will they be granted the status of BUPA Approved Physiotherapy Provider. BUPA stated wish is to provide their customers with proven quality physiotherapy at a fair price and close to where they live. There is also a drive to standardise the length of sessions albeit with consideration of clinical variables and to set sessional benchmark rates.

The prices indicated in BUPA’s tender document are:

Central London: initial assessment 55; follow-up treatments 45

Outer London: assessment 45; follow-up treatments 35

Rest of the country: assessment 40; follow-up treatments 30

The tender process asks about the facilities and services offered in the practice, the quality of service provided, the patients service experience ” the standard available, price and value for money and innovation and development. The BUPA review is not concentrated on physiotherapy as the have already adopted this approach to appraise magnetic resonance imaging and ophthalmology with reported savings of 10 million pounds.

Once BUPA has reviewed the tender submissions it may grant physiotherapists a contract for two years without increased prices. If things go well a two year continuation could be granted, with annual prices increases. Two hundred percent differences between physiotherapy prices are quoted by BUPA as indicative of anomalies, with costs varying between 25 and 85 pounds. Large cost differences can occur in practices which are geographically very close, and with treatment frequency for similar conditions varying from one to sixteen consultations it is these anomalies BUPA is trying to address.

Dr Rebecca Small, assistant medical director for BUPA UK Health Insurance, said: “Recent changes in the NHS mean that physiotherapists are increasingly being required to demonstrate the effectiveness of what they do in terms of clinical outcomes and cost. No such requirements exist in the independent sector. We want to work with physiotherapists and their representative bodies to address both the variation in the provision of physiotherapy and the cost for private patients so that together we can continue to deliver high-quality, evidence-based care and drive better value for our customers.

“We are also increasingly being asked by our customers for more information about the physiotherapists who treat them. Our new approach to physiotherapy will enable us to meet this growing need…. Our initiative is designed to offer customers high quality healthcare at affordable prices and, whilst it is disappointing that both organisations have decided not to support it, we respect their position.”

The Chartered Society of Physiotherapy (CSP) and PhysioFirst, the representative organisation of private practitioners, having been working cooperatively on this matter, indicating to BUPA the potential disadvantages of their approach. They have now instructed solicitors to present a formal case to the Office of Fair Trading against BUPA’s tender process.

The CSP chief executive Phil Gray has indicated that the BUPA price comparisons are unfair and inappropriate as they did not take into account the patient’s clinical condition nor the specialist expertise of the practitioners. He feels that patient choice and the operation of a competitive market are not compatible with the tender process and proposed new contracts. Market forces are impinging more and more strongly on both private physiotherapy and NHS physiotherapy provision and this is an example of this process becoming very obvious. Commercial competition is increasing as different organisations enter a market where many things have been done traditionally for many years. Improving business skills and making business cases have been recurrent themes recently in the advice and courses run by PhysioFirst and the CSP.

BUPA’s introduction of its recent tender process has caused anger and grave concern amongst private physiotherapists. BUPA is the largest private medical insurer in the UK and has been reviewing orthopaedic services recently, now moving on to the reported inequalities in private physiotherapy services. BUPA’s intentions are stated to be to look at the alleged inequalities in quality, cost and customer service in physiotherapy provision across the country. Six thousand physiotherapists have been effectively requested to enter a price competition to be allocated BUPA patients.

BUPA has asked physiotherapists and practices to complete the online tender process by Friday 24th April, covering information about customer services, quality, the practice and the base prices they can offer. Only if approved will they be granted the status of BUPA Approved Physiotherapy Provider. BUPA stated wish is to provide their customers with proven quality physiotherapy at a fair price and close to where they live. There is also a drive to standardise the length of sessions albeit with consideration of clinical variables and to set sessional benchmark rates.

The prices indicated in BUPA’s tender document are:

Central London: initial assessment 55; follow-up treatments 45

Outer London: assessment 45; follow-up treatments 35

Rest of the country: assessment 40; follow-up treatments 30

The tender process asks about the facilities and services offered in the practice, the quality of service provided, the patients service experience ” the standard available, price and value for money and innovation and development. The BUPA review is not concentrated on physiotherapy as the have already adopted this approach to appraise magnetic resonance imaging and ophthalmology with reported savings of 10 million pounds.

Once BUPA has reviewed the tender submissions it may grant physiotherapists a contract for two years without increased prices. If things go well a two year continuation could be granted, with annual prices increases. Two hundred percent differences between physiotherapy prices are quoted by BUPA as indicative of anomalies, with costs varying between 25 and 85 pounds. Large cost differences can occur in practices which are geographically very close, and with treatment frequency for similar conditions varying from one to sixteen consultations it is these anomalies BUPA is trying to address.

Dr Rebecca Small, assistant medical director for BUPA UK Health Insurance, said: “Recent changes in the NHS mean that physiotherapists are increasingly being required to demonstrate the effectiveness of what they do in terms of clinical outcomes and cost. No such requirements exist in the independent sector. We want to work with physiotherapists and their representative bodies to address both the variation in the provision of physiotherapy and the cost for private patients so that together we can continue to deliver high-quality, evidence-based care and drive better value for our customers.

“We are also increasingly being asked by our customers for more information about the physiotherapists who treat them. Our new approach to physiotherapy will enable us to meet this growing need…. Our initiative is designed to offer customers high quality healthcare at affordable prices and, whilst it is disappointing that both
organisations have decided not to support it, we respect their position.”

The Chartered Society of Physiotherapy (CSP) and PhysioFirst, the representative organisation of private practitioners, having been working cooperatively on this matter, indicating to BUPA the potential disadvantages of their approach. They have now instructed solicitors to present a formal case to the Office of Fair Trading against BUPA’s tender process.

The CSP chief executive Phil Gray has indicated that the BUPA price comparisons are unfair and inappropriate as they did not take into account the patient’s clinical condition nor the specialist expertise of the practitioners. He feels that patient choice and the operation of a competitive market are not compatible with the tender process and proposed new contracts. Market forces are impinging more and more strongly on both private physiotherapy and NHS physiotherapy provision and this is an example of this process becoming very obvious. Commercial competition is increasing as different organisations enter a market where many things have been done traditionally for many years. Improving business skills and making business cases have been recurrent themes recently in the advice and courses run by PhysioFirst and the CSP.

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