Private physiotherapists throughout Britain have been shocked and angered by the attempt by BUPA, the UK's biggest medical insurer, to push through new terms of service and contracts in return for being allowed to treat BUPA patients. BUPA has styled the review, which is not confined to physiotherapy services, as an investigation of value, service provision and quality, which they feel has inappropriate inequities across the country. This has resulted in 6 thousand physiotherapists effectively being required to enter a price competition for the privilege of BUPA patients.
The tender process initiated by BUPA involves physiotherapists and practices filling in an online questionnaire by Friday 24th April, setting out information about their practice, quality requirements, the best prices they can offer and parking offered. They will be allowed to be a BUPA Approved Physiotherapy Provider only if they pass this process. BUPA is reportedly looking to ensure high quality physiotherapy provision close to patients' homes at a good price, with an attempt to get session length standardised within clinical variability.
The prices indicated in BUPA's tender document are:
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
Physiotherapists and practices have to fill in a lot of information for the tender including their sessional prices and value for money, the experience patients have in their practice, quality of treatment and practice facilities. Physiotherapy has not been particularly singled out for this rather tough process as ophthalmology and magnetic resonance imaging have already been scrutinised in this way, apparently with a 10 million pound saving.
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.
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.
About the Author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, musculo-skeletal conditions, neck pain, injury management and physiotherapists in Brighton. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.
Get all the information and photos:: http://coringa.info/health/bupa-shocks-physiotherapy
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