BUPA Physiotherapy Tender Process

[thephysiosvoice]

Hallo

I think this is a great place to start.

In the UK we have been or are about to be told by BUPA (the UK's main PMI) that all Physio's will have to go to a blind tendering process to be able to treat and look after BUPA patients.

The prices they are quoting are for inner & outer London and the rest of the UK. The prices are nearly impossible to provide a profitable service. That is the least of our worries.

The biggest threat is to our clinical governance and clinical autonomy. The PMI's will be able to decide which patient is seen by whom and for how many sessions at whatever price they choose. This means that no matter what you clinically decide is best for your patient, the PMI will dictate how you treat them. BUPA's so called "quality" is non existant. This is about squeezing a very fragmented industry so they can make more money. Our relationship with our referring GP's and Surgeon's will mean zip. The cheapest will win, not necessarily the most clinically viable option succeeding.

BUT we can do something about this - if and only if we do something (and I know this all sounds a bit right on) about it. We've 6 weeks to mould and shape the future of the profession. As a unit we can do something.

Have a look at the very new blog thephysiosvoice.co.uk and add your comments. Tell your mates. Get scared, but you are not alone....

Cheers

TPV
info at thephysiosvoice.co.uk

Similar Threads:

• Help Needed in Finding Physiotherapy Tender Opportunities
• Advice to give patients on the BUPA tender
• bupa tender
• BUPA tender poll. Did you submit? Vote here
• Nuffield Physiotherapy Group tender to BUPA

[thephysiosvoice]

Afternoon

So today is the start of the Blind Tender Process - my computers broken and so I can't do it. Shame. Apparently it will be out of action for the next 6 weeks or so, or at least until Saturday 25th April

BUPA has announced that with all the money that they will save, should the process go ahead, they'll spend it on new drugs. And probably try and get rid of physio all together!!

Spread the love.

thephysiosvoice dot co dot uk

TPV

[Bupabear]

So, you charge £30 or less and into the fourth year of your agreement you are now allowed to charge up to 75p more! Get real.
Maybe Bupa should advise Labour on how to run the economy.

I AM NOT going to join this charade by BUPA. I am fortunate enough to have enough self funders not to play their game.

This process is similar to what happened to Dentists and the NHS. And what did they do? Maybe we should let the press know that Bupa patients are going to possibly be seeing less experienced physios, for less time and in less pleasant surroundings! And whilst I am here, this is even more hilarious for our osteopath colleagues who really do know how to charge for their services

Should have been a lawyer or merchant banker. Damn!

Up the revolution!!!

[maunger]

Hello,

First I would like to make a point that I am not one who gets involved in general discussion forums regarding physiotherapy issues.

However, recently, I have learned that BUPA have given all private clinics in the UK, 4 weeks to submit a blind tender for the business of BUPA subscribers. As a clinic I remember no other discussion or warning that this was coming about and to give us all 4 weeks to go about a blind tender seems generally wrong.

I have been searching on google and I believe that this is BUPA's big plan to bring all medical providers who are currently treating their patients in-line with their pricing structure. BUPA say that this is because of the large variations in physiotherapy fees and quality of treatment around the country, however underneath this when looking at the tender website they ask questions regarding internal audit and care pathways. It may be just me but aren't BUPA an insurance company? Is it really there role to establish whether physiotherapists on their preferred list are in fact taking part in these CSP standards (I personally think not). In fact it is the job of individual clinics to meet the CSP standards.

I personally believe that the tender is going to remove/devalue practitioners autonomy, as we all know you cannot bracket all patients into care pathways, try doing that for a patient with lower back pain.

Further to this, when looking at google I notice that BUPA have instigated tenders for MRI and Opthalmology. MRI was pushed through quietly and now those who signed up the agreement are regretting the agreement and the Opthalmologist's have out right rejected BUPA's proposal.

I would like to find other members who are concerned regarding this tender, we don't have very long and we may be signing up to something that we don't yet know all the facts about and how it may affect us in the long term. I am considering contacting the press to bring this issue to the forefront

Please contact me if this is a big enough issue for you and you want to do something about it.

My name is Mike Aunger

[archersusie]

Where do I start? SO much to say...
1. The BUPA tender is NOT about quality. It is ONLY a price cutting exercise! Be under no illusion.
2. Why are physiofirst and the CSP not doing more to support their members with this issue? It should be all over the press that BUPA are looking for cut price physiotherapy treatments and reducing patient choice?
3. Are BUPA going to reduce the number of osteopaths/chiropractors
and cut their prices too? I think not! And when your patients cant get a good physio with good skills because of this tender process, they will be going to the chiropractor/osteopath down the road!
4. How am I expected to maintain my CPD, improve and expand my skills and practice with a 30 quid treatment? Will the extra 75p in four years help fund it? I think not. Does Ms Gallagher spend more than 30 quid on her hair do? I think so!
5. What if I get the contract and am flooded with BUPA patients pushing out my other patients and in 4 years time dont get the contract- what happens to my practice then?
6. What if other Personal Health Insurance Companies follow suit and I have to charge all my patients 30 quid - I will essentially be working for 3 months of the year for free (a 25% cut in money coming in!).
7. How do BUPA plan to evaluate that the providers have these carepathways in place and clinical audits? If they did actually inspect them would it mean anything to them? Again, I think not.
8. Can anyone actually make head nor tail of the terms and conditions in this contract?
9. What about my clinical governance and autonomy?
Im angry, confused, stressed and annoyed by BUPA. I thought they were a reliable trustworthy company which provided good quality healthcare now Im not so sure and am wondering should I switch my healthcare provider. I dont want top be sent to the cheapest heart surgeon or the cheapest vascular consultant or have a cutprice hip replacement.
Im also let down by Physiofirst and the CSP - why oh why are they not doing more about this?

[thephysiosvoice]

Where to start.....

1. I think you are correct. This is a Walmart proposal. Stack 'em high, sell 'em low. Physio is just physio. Doesn't matter by whom or where or even what....really?
2. Physiofirst are spineless and don't want to tussle with the Big Boys incase their cred is dented and the CSP has to look to and protect the "majority of it's members" i.e not the group who represent the private sector. The CSP seem to forget that like it or not, the private sector is often the public image of physio and so should give us just a modicom of respect.
3. Chiros and Osteos only represent a small percentage of relative treatment cost, so go for the biggest group - us.
4. Forget CPD. Read Frontline - that's 50% of your yearly CPD. Do it twice - et voila.
5. Eggs in one basket....
6. Unfortunately they will if this is allowed to succeed.
7. BUPA have an elaborate method of assessing and evaluating by getting us or monkeys to fill out an online form
8. No. I'm sure your folks always told you to be careful what you put your signature to - and if in doubt, don't.
9. If BUPA get their way we wont have to worry about this. We'll be told what to do, to what bit for how long. Think dank basements, think robots. Forget 2012 and the Olympic Dream.

You are not alone - the more I listen the more I hear other Physio's crying out for help. We're a pretty mean bunch when we communicate with one another and get things done.

The Physio's Voice is there for every single Physio in the land to have a voice. If you get a lot a people in a room and all whisper, you actually make quite a racket....Please look at the blog thephysiosvoice.co.uk and get involved and tell your mates too.

Cheers

TPV

[RLStov]

As you have so rightly said physiotherapists need to think very carefully before agreeing to BUPA's tender agreement.
The idea of a PMI calling the shots on how we treat our patients is a very worrying prospect.
We fought to stop the medics from telling us how to treat patients more than 20 years ago! This is huge backward step if not even more concerning as I doubt if the decisions will made by exeprienced clinicians.
I am baffled as to why the CSP and or Physiofirst aren't more interested in this issue, I understand why they can't discuss costs and pricing but this is about the errosion of our professional autonomy.
I have friend who runs a practice in the USA and if you want to see where this is heading look no further.
She is told by the insurance company, to treat a patient so many times for a particular condition and no more.

[Bupabear]

In this world Bupa divide and rule. Having been told by Bupa that I could only charge patients at the agreed discounted rate, I then find out at a recent course that other physios have been allowed to charge their patients for the shortfall in the Bupa agreed rate compared to their normal rate. Just like Bupa allow the top surgeons to do.

It all boils down to this: we are clinicians not technicians. We are worth more than a 75p wage rise over four years.

75p is the key in the pricing argument in this campaign. 75p, that's all your skills are worth in the world according to Bupa.

[physiobob]

Maybe we should let the press know that Bupa patients are going to possibly be seeing less experienced physios, for less time and in less pleasant surroundings!

Here here on that one. I think the press would like to know a lot about BUPA's new reg's. Firstly, that their clients don't get their choice of practitioner, merely BUPA's choice of the cheepest tenders, second that they are working against the European laws on age descrimination by preventing people with less than 5 yrs experience (without any clinical basis) work on their clients. Thirdly that some of the NHS backlash for no jobs is due to the private arena not taking anyone less than 5 yrs post graduation and therefore no open job opportunites are appearing in the NHS.

And the list goes on. They are even restricting trade by charging £53 per half hr appointment at their BUPA wellness clinics (one around the corner from mine) but they insist I can only charge £45.

I back a total boycott of the tender process and we tell clients that we DO NOT see BUPA members. Let's hit them where it hurts, their membership, and get their patients to walk elsewhere.

[archersusie]

I agree the press should know about this process and how it will affect all BUPA subscribers. I myself am a BUPA member and a provider (for the next 4 weeks anyway), I need to see a vascular consultant - are they going to send me to the cheapest, or the best? That aside, BUPA can do what they want and provide the kind of service they wish to pay for. I personally believe they are shooting themselves in the foot.

I would like to know what the csp and physiofirst have done to fight this? Did they break the cost of a physiotherapy treatment down for BUPA, did they explain that we all must have insurance, PLI, up to date CPD, good surroundings with heat electricity, parking, good administration, good up to date serviced equipment, access for disabled clients, time to complete notes, communicate with doctors, consultant etc, that we need to pay rates and so on. None of this discussion involves price fixing, its just about informing BUPA what it costs to run a good, well expereinced, efficient physiotherapy clinic. The CSP and physiofirst have washed their hands by saying they cant talk to BUPA about this due to the competition laws. They can however, talk to BUPA about the true cost of a session of physiotherapy in real terms and the implications of unrealistic pricing, they can advice their members and provide support.
I heard a rumour that a motion to be discussed at Congress on this issue was declined - why? Simple question!

[archersusie]

Legal implication! Can someone help me with this issue?
If I dont qualify for this BUPA tender and am suddenly deemed to be below standard as set by BUPA, will the CSP defend this slur on my professional ability, even though I comply with the standards of practice set by the CSP and HPC?

[physiobob]

Let's look at the BUPA issue in recent years. I might add I have written to the CSP and the OCPPP (entire committee) on several issues about this in the past few years and have had little CSP response and NO OCPPP response.

I think it's time perhaps the UK's private practitioners looked at forming a new association?! Maybe then they will listen.

Firstly the age discrimination issue:

In October of 2008 the European law stipulated that you could not discriminate on age for any job application. Immediately BUPA fell in breech of this issue as by demanding 5 yrs post grad 'experience' (actually time past) to be on their books. Effectively this says that no one under the age of 26-27 can apply for this job contract with BUPA. (18 yrs + 3 for the degree + 5 for experience) So 27 is a minimum.

I questioned BUPA on their guidelines for the 'level of experience' required at the time and they said there was none, it was 5 yrs and that was that.


Secondly the 5yrs + and BUPA's own wellness clinics.

I am sure everyone knows that BUPA themselves recruit graduates of less than 5 years experience into their own clinics (some as little as 2 yrs). They justify this by saying they are under the observation of those with a minimum of 5 yrs experience. Not quite sure who they think we private practitioners are.

The result of the above is a restriction of trade issue

Thirdly, BUPA have told me I can only charge £45 for a half hr session when their clinic around the corner charges £53. This is ant-competitive and a restriction of trade.

All of the above point, and more, have been brought to the attention of both the CSP and the OCPPP

Let's go on.

In 2006 I wrote to the CSP explaining that the big issue lying ahead for new grads was this 5yr + issue and BUPA (and perhaps PPP who has stopped all physio's registering with their service).

Effectively what that meant was that no one under 5 yrs was going to leave the NHS as NO private practitioner was that keen to employ them without recognition of the health care companies. No one leaving means NO new jobs for new grads within the NHS.

By the time someone spends 5 yrs in the NHS they are unlikely to move into private practice. Thus no seniors leave either, the result even less new grad positions.

No let's look at the culling of the BUPA list under the current scheme, even less BUPA approved practitioners, practices will shrink, there will be more solo ([professionally isolated) practitioners and even LESS jobs for any physio outside of the NHS. Therefore no incentive to leave the NHS and NO new grad jobs for the future of the physio profession in the UK.

No I am taking a slightly extreme view on this but it will not be far from the outcome as I say this and the later ramifications whilst working in Canada in the 90's. Interestingly a similar situation that BUPA is trying to create was eventually deemed anti-competitive under the Canadian law and these super-clinics for the mass market has to disband their exclusive agreements. So BUPA will possible gain for a while but not forever.

This is an issue for the whole profession, not just the private practitioners. The NHS, the current new grads, the current students and the future students.

I would support a boycott of the tender process by the entire profession. I would also welcome media interest in this issue as BUPA are no longer offering their clients the practitioner of their choice. They will be offering one of BUPA's choice based on the cheapest offer on the table. No well established, well qualified and conscientious therapist will enter this agreement. Once their members know about it, let them react by walking. The media could have a field day with this.

Please make your comments and no that there will be a physio meeting held in central London next week (perhaps wed the 8th April) to discuss this on mass.

Watch this space.

OH and by the way the CSP continues to take advertising from BUPA for their inserts in the frontline publication. I also complained about this several times and they even printed my letter but did nothing about it. I suppose when their mismanagement has lead to financial problems they even take money from the enemy…Such a short-sighted approach to all their members’ livelihoods.

[Bupabear]

I think this will be the end of the OCPPP. They have been shown to be spineless (excuse the pun). I never expected the CSP to get involved. I am 52 and when I qualified it was considered the eighth deadly sin not to work in the NHS. Why should our NHS colleagues be worried about us greedy private practitioners charging such a large amount for treatment?

Yes let's have a boycott. Sod the lot of them. If we agree to cut our costs and lose are clinical autonomy to one insurer, the rest will jump on the bandwagon. How would you answer the question from AXAPPP " Why do you charge us more than Bupa?"

Maybe when we move away from these stupid Bupa prices, we can go on and move towards charging a proper rate. We are clinicians but get paid technician wages in the NHS and that's what Bupa think we are.

The Daily Mail might be sympathetic to our cause, what does everyone think?

[pragmatic pat]

I would like to voice my support for a mass exodus from BUPA. We are all working privately to be autonomous practitioners and as such able to provide a flexible service to deal with our differing patients variable needs. This would be swept away in an instant and we would be culpable in the demise and undermining of our profession
This contract is belittling and demeaning. I will not be tendering , am prepared to take the substantial financial hit to defend my position as a professional rather than a paid assistant.

As we are the only practice for an 8 mile radius it will be interesting to see how BUPA are going to fulfill their proclamation to still offer physio close to where patients live.

[pragmatic pat]

Further to my post I realise sadly that i am the only woman who has come out in support of a buoycott.....please..... someone tell me i am not alone???

[thephysiosvoice]

NO! You are not alone.....

TPV

[physiobob]

Let's boycott it all together. Let's all talk about it. Let's inform the media. And tell everyone offline too. p.s. Sorry about the site being down overnight. Our hosting company had a meltdown and many were affected. Glad all is back online now

[physiobob]

Here's an interesting report I found online about this issue with the MRI professionals

Hospital files complaint on Bupa as it fails tender process

Bupa could be probed by the Office of Fair Trading (OFT) following a complaint from a hospital about the insurer's new network arrangements, writes Kirstie Redford.
St Anthony's Hospital in Surrey filed the complaint after Bupa conducted a national tender of routine elective out-patient MRI scans earlier this year. The hospital failed the tender process meaning that patients have to go elsewhere for scans, despite receiving the rest of their treatment at the hospital and listing St Anthony's as their preferred provider.

Brian Clarke, hospital director at St Anthony's, said altering network arrangements undermined the whole concept of private medical insurance (PMI). "The move by Bupa goes against the heart of PMI, which is that patients have the choice of where, when and by who they get treated," he said.

Clarke added that narrowing the choice of radiologists could put the quality of treatment in jeopardy. "Operating surgeons choose radiologists very carefully and often work closely with them so that they can speak the same language when interpreting results. Separating reporting radiologists from surgeons has already led to requests for repeat scans," he said.

Lara Gorman, spokesperson for the OFT, confirmed it had received a complaint from St Anthony's saying it had been unfairly prevented from joining Bupa's preferred provider network for MRI scans. "The OFT is currently still considering the substance of this complaint," she said.

Natalie-Jane Macdonald, medical director of Bupa UK Health Insurance, said the objective of the tender was to ensure consistent quality of service, together with fair pricing. She said: "St Anthony's was unsuccessful because it was too expensive. The hospital was given the opportunity to improve its pricing during the tender process but chose not to do so."

[Bupabear]

Are "Blooper" intending to impose a similar tender process on orthopaedic surgeons? Anyone know? They might be useful allies for us: imagine a surgeon not been able to refer to a physio they trust.

One very interesting point in the letter we received from Bupa is when they say they would only be able to guarantee pre-authorisation to physios in the network. Reading between the lines, does this say:

"If you are a corporate member, we don't want to upset your company so we will allow authorisation in this case."

or

"Don't shout at us and threaten to withdraw your membership, we will allow pre-authorisation in this case."

Any thoughts on this ambiguity?

[markphysio]

Spoke with Roger Hint Customer Relations Officer (0207 306 6695) from the CSP, and Chris Hammacott (0207 314 7839). Both men were very helpful, firstly Chris pointed out the standard line that the CSP could not be seen to directing members as to what to do, etc. as we have heard before.

Later in the afternoon I spoke with Roger who said that due to the large volume of calls received regarding this matter the CSP in conjuction with the OCCCP (check the website this evening for further news I was informed) were now considering a media campaign to highlight our issues and even examining legal alternatives as to what can be done to protect THEIR/OUR membership, which I think they initially failed to take into full consideration. The CSP is our governing body, and it is up to us to continue the pressure so that our collective voices are heard.

I think all the issues that have been raised in this forum and the physiosvoice.co.uk, are excellent ones and their is no need to re-hash them, but I emplore you all to be passionate about this matter and continue to keep fighting the good fight.

cheers mark

[thephysiosvoice]

Good work.

This is what we need. We need the support of the CSP. The more we "hassle" them, the more they have to take notice. By hook, or by crook.....

Spread The Love

TPV

[physiobob]

Don't bank on the CSP doing anything. They are probably only calming the waters by saying they will assist. Any media campaign organized by them is likely to have little affect, be to soft and be to late. Afterall they continue to book and advertise BUPA in their frontline publication!

There is now a meeting scheduled for Wednesday, April 8th at 7pm in Central London. UK physio's on this forum and on our Physiobase membership will receive details with more information. We are trying to invite all local london press. Stay tuned...

[markphysio]

What about inviting representatives of other health insurance providers PPP, PRU etc.. who might be able to offer discounted membership to BUPA members who wish to continue with their choosen physio. This discounted membership could roll out till the patients BUPA membership finishes, and then the member joins the new Insurer.

Be guarenteed that BUPA will more than likely have a 'spy' in the midst of the Wed. meeting, so let them know we are prepared as a collective group know that we will be informing our patients/their members about their actions, and suggesting that might want to change providers. Just a thought.

Also note that Bupa physio's working in their own private clinics are being subjected to the same measures and are definately on our side.

cheers mark

[Wendy Emberson]

Physio First/OCPPP have been in negotiations with Bupa and all the other major insurers for many years. They have fought long and hard for us and do not deserve the comments that they are not doing anything. The difference here is that, as when Bupa first started the pilot contracts in the North East some years ago, the competition act effectively gagged them and the CSP. It does not mean that they have been doing nothing. What is also different about this scenario is that with sites like this and Icsp then physios have the opportunity to know what is going on and get active!
I spent 15 years on the committee for OCPPP, and believe me, the members of that committee work exceedingly hard - and are working physios just like the rest of us. This situation affects them as much as the rest of us and if there was a way round it they would have found it. Unfortunately it is now down to individual physio power. Let's go for it!

[ckaren]

I too am in favour of a boycott of the BUPA tender - where BUPA lead with this others will follow.