BUPA Shocks Physiotherapy
Physiotherapists across the country are angry and disappointed at an attempt to drive their prices down by BUPA, the health insurance provider. The UK's largest private medical insurer has been conducting a review over the last year into the provision of orthopaedic services, which includes independent physiotherapy provision. Their view appears to be that the cost and quality of physiotherapy provision varies across the country, in some cases representing poor value to customers. The result is that 6,000 physiotherapists have effectively been asked to compete on price for treating BUPA patients.
Physiotherapy practitioners must complete an online questionnaire by Friday 24th April, with questions about the practice, parking and lowest prices they are prepared to accept. Only then will they have a chance of becoming a BUPA Approved Physiotherapy Providers. The stated point of the tender process is to provide to BUPA customers high quality physiotherapy close to where they live and at a fair price. They also want to standardise session lengths with some allowance for clinical variation and to establish benchmark rates per session.
BUPAs tender document indicates the prices as:
Central London: initial assessments 55; follow-ups 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."
PhysioFirst, representing private practitioners, and the Chartered Society of Physiotherapy (CSP) which represents the vast majority of physiotherapists in the country, have been working together on the problem and talking with BUPA to try and resolve matters. They have indicated there may be disadvantages to the approach taken by BUPA and have now formally presented a case via their solicitors to the Office of Fair Trading.
Phil Gray, chief executive of the CSP, has called the price comparisons used by BUPA unfair and inappropriate because they have both ignored the variations in clinical conditions in the patients and levels of specialist expertise in the clinicians themselves. He indicated that complete patient choice and a fully competitive market are not consistent with the proposed tender and new contracts. Both NHS physiotherapy provision and private physiotherapy are being increasingly impinged upon by market forces and business processes, the BUPA tender being the most marked recent example. New organisations are entering the market which is ripe for revision of traditional practices which have not altered for years. Both the CSP and PhysioFirst have been encouraging business awareness and skills by advice and running courses.
Physiotherapy practitioners must complete an online questionnaire by Friday 24th April, with questions about the practice, parking and lowest prices they are prepared to accept. Only then will they have a chance of becoming a BUPA Approved Physiotherapy Providers. The stated point of the tender process is to provide to BUPA customers high quality physiotherapy close to where they live and at a fair price. They also want to standardise session lengths with some allowance for clinical variation and to establish benchmark rates per session.
BUPAs tender document indicates the prices as:
Central London: initial assessments 55; follow-ups 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."
PhysioFirst, representing private practitioners, and the Chartered Society of Physiotherapy (CSP) which represents the vast majority of physiotherapists in the country, have been working together on the problem and talking with BUPA to try and resolve matters. They have indicated there may be disadvantages to the approach taken by BUPA and have now formally presented a case via their solicitors to the Office of Fair Trading.
Phil Gray, chief executive of the CSP, has called the price comparisons used by BUPA unfair and inappropriate because they have both ignored the variations in clinical conditions in the patients and levels of specialist expertise in the clinicians themselves. He indicated that complete patient choice and a fully competitive market are not consistent with the proposed tender and new contracts. Both NHS physiotherapy provision and private physiotherapy are being increasingly impinged upon by market forces and business processes, the BUPA tender being the most marked recent example. New organisations are entering the market which is ripe for revision of traditional practices which have not altered for years. Both the CSP and PhysioFirst have been encouraging business awareness and skills by advice and running courses.
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