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

[physiobob]

Hello Everyone,

I have been following developments from a distance and I admire and commend the tenacity and resolution of the members posting their comments.

However if I may I would like to play the devil's advocate on the whole process.

Is it possible that BUPA have factored in the physiotherapist's reaction to their tender process.

Now let's assume that every tender that is submitted before the deadline is accepted on the list of "approved providers"


So in effecct I may be a Patient of my chosen therapist
Then I suddenly have problem that I need help with.

I follow my normal "clinical care pathway" (They do not actually start with the therapist )

They phone BUPA and I give my preferred therapists name.

BUPA then tell the patient that their preferred therapist is not on the list of approved providers.

The patient asks why and BUPA says "We are unable to disclose that information. We suggest that you direct that question to your therapist"

Sorry but a bit long winded; here's the point.

Supposing that BUPA accept EVERY physio who has "tendered" (To me personally an erroneous word in this context) a contract to provide services for their patients.

In effect:

We have self policed our profession

Taken the onus off BUPA to legislate who is fit to effectively practice

And they can turn around and say "Every physiotherapist that tendered has been included on the list of BUPA recognised providers. Why your specific therapist did not tender is not within our control.We suggest that you ask them directly the reason for their decision not to tender"

Put our own regulatory bodies in a ( in my personal opinion) in a dim light somewhat.

Last Thought. If this did happen and BUPA accept every tender submitted then the therapists who did not tender have in effect done BUPA's job for them.
If hypothetically every physio tendered, then it would be up to BUPA to decide which therapists were not up"to the mark".

As I understand it they would then have to decide who they would or wouldn't accept as service providers.

Surely it would be easier for the CSP an PF to fight individual cases on this basis.


I welcome your input on this issue

This is why no one should tender. Right now I no of almost no one in central London who is tendering, If BUPA want to rule out the main medical postcodes of the capital (which i had heard they were also going to do in the tender) then their patients will walk.

The inside word from within BUPA is that only a trickle of people have tendered. More than that BUPA have even been calling practised who havent yet submitted tenders asking them if they need help with their tender applications. Seems the NO vote is working in our favor as the number to provide a continuity of care for their customers is simple not enough. I also hear that physio's from the Nuffield group are not permitting that group to tender to BUPA on behalf of the group. I have read posts today saying that they have infact told Nuffiled that they are not endorsing that move, so this will further destroy BUPA's agenda.

We do need devil's advocates but it is clear weneed to stand together on this.

Patients want to see the people they want to see. If a PMI doesn't offer that then many will walk to competitors. We should be forcing that hand and let the PMI customer contract be the only point of negotiation.

BUPA are letting down their customers, not the physio's who are only offering to provide first rate care to an organisation (BUPA) that has already approved as appropriate to provide that care. Nothing else has changed.

[Mr Manipulator]

Send the legal info link to the following (the more that do, the more attention it will get):-

jane.dreaper@bbc.co.uk

richard.hannaford@bbc.co.uk

[alasdairjon]

Send the legal info link to the following (the more that do, the more attention it will get):-

jane.dreaper@bbc.co.uk

richard.hannaford@bbc.co.uk

where is the legal info link, could you post it please?
Additional Comment I forgot:

This is why no one should tender. Right now I no of almost no one in central London who is tendering, If BUPA want to rule out the main medical postcodes of the capital (which i had heard they were also going to do in the tender) then their patients will walk.

The inside word from within BUPA is that only a trickle of people have tendered. More than that BUPA have even been calling practised who havent yet submitted tenders asking them if they need help with their tender applications. Seems the NO vote is working in our favor as the number to provide a continuity of care for their customers is simple not enough. I also hear that physio's from the Nuffield group are not permitting that group to tender to BUPA on behalf of the group. I have read posts today saying that they have infact told Nuffiled that they are not endorsing that move, so this will further destroy BUPA's agenda.

We do need devil's advocates but it is clear weneed to stand together on this.

Patients want to see the people they want to see. If a PMI doesn't offer that then many will walk to competitors. We should be forcing that hand and let the PMI customer contract be the only point of negotiation.

BUPA are letting down their customers, not the physio's who are only offering to provide first rate care to an organisation (BUPA) that has already approved as appropriate to provide that care. Nothing else has changed.

Please don't make it a London issue. We are all delighted with the volume of your voice, but don't risk alienating regional physios...

[fizziophil]

What if you know of other physios inyour area have already submitted a tender?

[alasdairjon]

What if you know of other physios inyour area have already submitted a tender?

my sympathies are with you, we are in the same boat, but I hope that my resolve to protect the profession is stronger than those who have been cajoled into tendering. I guess we have to stand up and be counted!

[JacobI]

I know of two physios in my immediate area who have reluctantly tendered, before the legal challenge today. I just cannot follow them, my clinical autonomy and commercial independance is too precious to me. I have had a lot of support from my medical colleagues, which has been of great comfort. Those of you still wavering - please stand firm, our profession needs it.

[Jill Wigmore-Welsh]

Some Physios have said that BUPA has phoned their practice several times this week, and this comment appears to reinforce a belief that therefore BUPA are 'worried' that Physios wont tender. Reiterating comments made earlier, could it be that BUPA could have anticipated a negative response from Physios ? Isn't it possible that non tendering practices are being contacted just so that when the tender deadline of 12pm tomorrow evening passes...well its passed.
A tender dealine is just that, and I am unconvinced that droves of Physio practices wont tender.

I spoke to BUPA today with regard to an issue raised over taking on a contract then wanting to get out for varied reasons, and found the dialogue to be as reasonable as any conversation I have had with a corporate.

While I recognise that there are many negatives to this whole process. Our profession has left chinks, and let us be mindful that this issue is less to do with the tender than our whole professionalism as Physiotherapists.

Perhaps we need to project ourselves further to the future and rather than directing anger at BUPA, who seem really just to be acting as a business. Maybe we could be reflective over where our seeming trust in the CSP to manage the direction of Physios in indepnedent practice came from.

With regard the derisive comment from Physiobob with regard my suggestion of a Physioplan concept. The actuality is the same in Dentistry and Chiropractic professions yet Dentists and Chiropractors have great insurance policies for their professions

[alasdairjon]

I would like to share the opinion of the Federation of Small Businesses legal advice team, who, when appraised of the situation, suggested that we would be better off tendering. Not by accepting all the various clauses, but by filling it out as we see fit. However, they did advise us to ensure we included our strong opposition to the nature of the tender, and state the reasons why we oppose, on an idividual clinic basis. I was advised that this would allow us to shift our position at a later stage, if a legal challenge were successful (which will take months, if not years).

Jill is absolutely spot on. BUPA are apparently acting to boost their profits and further secure their empire. They are a business, not an empathetic, conscientious, professional Chartered Physiotherapist. We cannot blame them for trying, but we should be far stronger in our response to them. Physios have proved what a divided bunch we are, and really invited this action upon ourselves. The shame is that there are certainly those that have already, and will still tender, regardless of their moral compass, because of the fear engendered by a large company laying down terms and conditions, and as suggested in previous posts "putting a gun to our heads".
Fingers crossed for tomorrow. Call your local MP's, any legal representative you know, and bombard the media. Protect the profession.

[physiobob]

It disappoints me to read the few posts above this one about people considering tendering for a contract based on what seems like short term interests. I understand people financial consideration given their current reliance on BUPA however if that is not your situation then I can see no hesitancy in NOT tendering. This is not a regional issue (as I have said many times), this is an issue for the entire profession, students, new graduates, NHS physio's and private practitioners. To be honest it is enough to make me consider hanging up the clinical hat. The majority of people are not tendering, not to mention the 30,000+ physio's who would not have receive one anyway. BUPA does have over 12,000 physio's on their books and they haven't let anyone else on them for years (newer grads that is). If a small number of practices in the UK tender and 99% do not the BUPA does not have any opportunity to change the current relationships. Nor will they be in a position to step into the NHS as the preferred provider. I will be standing firm. This is a long-term position for the stability of my business. If some of you wish to go the way of the TESCO farmer then so be it. Perhaps those that so should read the book Tescopoly!

[physio007]

please everyone do not submit a tender. I know a number of practices have done so in my region and are doing so at their normal rates. Surely they will just get rejected......? And then what? You have accepted their terms and if you re negotiate it will purely be based on price
If we are just negotiating our services on price, at what point does our long established profession turn into the oldest profession

[TCM003]

I tried sending an email to Jane Gallagher last night requesting further clarification. I have received what appears to be an automated response.

Please be advised that the deadline for submitting your online tender is midnight on Friday 24th April 2009.

Due to the volume of emails we have received and this fast approaching closing date, we are unlikely to be able to respond to your email prior to the tender closing date. We therefore suggest that you phone our Physiotherapy Tender helpline with your query; 0845 600 4078, open Monday - Friday, 9 am - 5 pm.

Once you have completed your online tender, please use the PRINT icon at the top of section 10 to print out two copies (we recommend that you also print out an additional copy for your records). Check that this has successfully printed, and then use the SUBMIT icon to despatch your tender to Bupa. Once you have submitted your tender you will be unable to print any additional copies.

Please sign two copies of the printed contract and return them in the postage paid envelope included with your invitation to tender letter.

With kind regards
Physiotherapy Tender Team
Bupa, Thames Side House, Staines, Middlesex TW18 4TL
T: 0845-600-4078; physiotender@bupa.com
Please consider the environment before printing this email.

I then followed the advise above but all the advisors were busy so I left contact details and emailed the physiotender address. Response

Please be advised that the deadline for submitting your online tender is midnight on Friday 24th April 2009.

Due to the volume of emails we have received and this fast approaching closing date, we are unlikely to be able to respond to your email prior to the tender closing date. We therefore suggest that you phone our Physiotherapy Tender helpline with your query; 0845 600 4078, open Monday - Friday, 9 am - 5 pm.

Once you have completed your online tender, please use the PRINT icon at the top of section 10 to print out two copies (we recommend that you also print out an additional copy for your records). Check that this has successfully printed, and then use the SUBMIT icon to despatch your tender to Bupa. Once you have submitted your tender you will be unable to print any additional copies.

Please sign two copies of the printed contract and return them in the postage paid envelope included with your invitation to tender letter.

With kind regards
Physiotherapy Tender Team
Bupa, Thames Side House, Staines, Middlesex TW18 4TL
T: 0845-600-4078; physiotender@bupa.com
Please consider the environment before printing this email.

[Physiomac]

So its the 24th do we tender do we leave it
should we accept the £30.00 personally i suggest that all of us outside london should if submitting then submit a significantly higher fee why should bupa force private practicioners to fix prices for 4YEARS with a 75 p increase when their own hospitals charge significantly more
if we go in then go in at higher rate say at least £35.00 or higher or shall we all stay resolute and not tender its a bit of poker texas hold em is in not
personally i would like to tell Bupa to ******* why should they tell us what to charge or what to treat we all have clinical expenses that differ and different skills why should London have a higher rate ...has anyone seen the cost of premises up here esp in glasgow edinburgh are we second class citizens in Scotland is it discrimination? we could play the race card!!!! just venting what we are all thinking on this last day ..the choice is yours
your thoughts please

[Mr Manipulator]

My thoughts are quite clear. Why have we not seen a response from either BUPA, CSP or PF to the lawyer's letter sent last evening?

See: thephysiosvoice.co.uk

[physiobob]

My thoughts are quite clear. Why have we not seen a response from either BUPA, CSP or PF to the lawyer's letter sent last evening?

See: thephysiosvoice.co.uk

Because the lawyers, finally via the CSP, only sent it yesterday afternoon. Don't expect any reply until next week.

This is the current auto email response from Jane Gallagher's email at BUPA if you do email her to make an enquiry. I suggest everyone NOT tendering sends her an email outlining that fact.

Seems she is not directly answering any questions before the deadline!

Gallagja@bupa.com

Interestingly, I sent her an email this morning and DID NOT get an automated reply. Perhaps she is pasting replies to those she see's fit to send an moderated auto-rely to?

If your query is about the physio tender please be advised that the deadline for submitting your online tender is midnight on Friday 24th April 2009.
Due to the volume of emails we have received and this fast approaching closing date, we are unlikely to be able to respond to your email prior to the tender closing date. We therefore suggest that you phone our Physiotherapy Tender helpline with your query; 0845 600 4078, open Monday - Friday, 9 am - 5 pm.

Once you have completed your online tender, please use the PRINT icon at the top of section 10 to print out two copies (we recommend that you also print out an additional copy for your records). Check that this has successfully printed, and then use the SUBMIT icon to despatch your tender to Bupa. Once you have submitted your tender you will be unable to print any additional copies.

Please sign two copies of the printed contract and return them in the postage paid envelope included with your invitation to tender letter.

With kind regards
Physiotherapy Tender Team
Bupa, Thames Side House, Staines, Middlesex TW18 4TL
T: 0845-600-4078; physiotender@bupa.com

[physiobob]

Also here is a useful posting from thephysiosvoice for a short simple email to Jane Gallagher at BUPA - Gallagja@bupa.com This is almost exactly what I sent her this morning..

We do think NOW is the perfect time to email Jane Gallagher saying ” I have received preliminary advice indicating there are a number of problems with the contractual terms proposed by BUPA. In particular the requirements in relation to the management and processing of insurance claims on behalf of BUPA in addition to being exceptionally onerous may be illegal. I am always willing to negotiate the terms for the provision of your services with your purchasers. I am currently unable to provide a response to the tender offer until I have received detailed clarification of the advice. I will be in touch again once I have received satisfactory clarification. Meanwhile I will continue to provide physiotherapy to BUPA’s members on the basis of the current terms of business…..” or something!!

You might also be concerned with the clear conflict of interest arising from BUPA’s ownership of BUPA Wellness and it’s provision of physiotherapy services. You might want to ask for written confirmation of how BUPA propose to ensure that there is a level playing field. You might also want to touch on the concerns about clinical governance the proposed pathways - just read many of the posts on this site

[physiobob]

Just In! The Latest eMail Alert from Physio First

Bupa Tender

Do remember that if you decide that this process is suitable for your practice then today is the last day that you can submit your tender. Bupa will close the tender process at midnight tonight, 24th April 2009.

Physio First has a message for its members from the CSP’s Chief Executive.

Bupa Tender: Further Update from the CSP

CSP and Physio First, the Society’s recognised occupational group for private practitioners, working together, are continuing to seek additional changes and clarifications to the BUPA tender process. This is to add to the significant number of alterations which were achieved in a recent meeting with BUPA and which are already on the CSP website and which have gone out via Physio First’s email alerts. These matters reflect a number of major concerns which have been expressed by Physio First and CSP members.

One of the most significant changes from our meeting with BUPA was that they backed away from their previously stated position of seeking to cut radically the number of private practitioners treating BUPA patients. They have accepted the arguments we made for the need for patient choice and local access. They have stated that they expect that a similar number to the current 6,500 practitioners to be included (subject to their tender process).

Yesterday, lawyers on behalf of CSP and Physio First sent a further letter to BUPA seeking further clarifications on three issues of the tendering process, questions about the Financial Services Act and the role of the BUPA Wellness company as a potential bidder in the tender. These are further issues raised by members.

We are aware that BUPA have responded quickly, denying there are any problems with the issues we have raised, including a denial of any competitive advantage of BUPA Wellness. Further discussions will take place between legal representatives on this.

Conclusion

The CSP and Physio First have been very active and working in close partnership to seek changes to the BUPA tender process since they announced it in late March 2009. The closing date for tenders remains midnight today – Friday 24th April.

Physio First and CSP do not like or approve of the tender process. It is clearly BUPA’s intention to seek to reduce their total costs by this tender. They claim that physiotherapy is one of their largest costs. We have instructed our lawyers to submit a formal complaint to the Office of Fair Trading (OFT) that BUPA may be potentially abusing its dominant market position in health insurance by its approach on this tender.

However, as explained elsewhere on these web pages, a public tender with independent contractors is covered by the 1998 Competition Act. That Act means that there are legal limits to what can be done. Any attempt by organisations to recommend reasonable fixed prices to practitioners or any effort to encourage a boycott of the tender process, would mean that the CSP / Physio First was breaking the law. We are not going to do that. The decision on whether or not to participate in the tender is for each practitioner to decide.

Instead, Physio First and CSP have been seeking positive clarifications and changes made to the tender process which reflect many of the concerns which practitioners have raised. A number of those changes have been achieved. We will continue to seek further improvements where possible, which keep members of both organisations, informed of significant developments.

Phil Gray
Chief Executive
CSP

24th April 2009

[Mr Manipulator]

Extracts from Phil Gray’s (CSP CEO) statement 24.4.09:-

“if you decide that this process is suitable for your practice”

“Physio First and CSP do not like or approve of the tender process. It is clearly BUPA’s intention to seek to reduce their total costs by this tender.”

“The decision on whether or not to participate in the tender is for each practitioner to decide.”

What do these add up to?..............DO NOT TENDER!

Wait and see what happens when the dust settles and BUPA are left with an inadequate network for their Members.

[Chartered Physiotherapist]

Well done to everyone on this site. I will not be tendering. If Bupa do change the goalposts and redo the whole thing then they will need to listen to us first.

[JacobI]

I would like to respond to Alasdairjon #108 - you can't tender without signing the Terms and Conditions, so even if you leave some bits blank on the tender document, you have still agreed to the T&C, so what's the point?
I also sent an email to Jane Gallagher, with a copy to the Tender team, and got the same automated message.

Please - don't waver, don't sign your profession away!!

[Deedee]

I have finally reached my decision and sent an email to Jane Gallagher stating the following:


On careful consideration, I find myself unable to agree to all the proposed terms and conditions of your tender.
I would, however, be more than happy to continue treating your clients under the terms and conditions of my existing agreement with yourselves.
As such I would like to submit my existing agreement with BUPA in lieu of my online tender



Thanks to all concerned for the fantastic job you have done, the great website and most of all the forum.
Well done and fingers crossed !

[physiobob]

here's a pure gem from someone who sent a letter to Jane Gallagher as a word attachment (perhaps the most common attachment on the web). I think you can even open a word document as text if you had to.

Dear All,

I got this response and a subsequent phone call from BUPA today.

I think that it is surprising that they don't have Word 2007 but maybe that is why they are trying to cut costs!

Has anyone else had a similar e-mail about future opportunities to tender?

Michael

"Dear Mr Nicol

I am sorry we are not able to read your attached letter as it is in a
Word format which is not compatible with Bupa's computer system. I am
sorry I was not able to contact you by phone this afternoon.

The deadline for submitting an online tender is midnight tonight, and
the phone lines close at 5pm. If you miss the deadline, you will see on
the Bupa therapies online website a notice later in the year regarding
arrangements for further opportunities to tender, if you so wish."

And another... I think it's going to be a long night for Ms Gallagher. Looking forward to my response but nothing received as yet.

I just received the response below to an email I sent claiming that I felt I was unable to tender due to many of the reasons that we have been discussing. They still seem to think the bullying tactics will work obviously, and are also not able to accept that changes have been made and further clarity is required. Anyone else had similar? Paul

From Jane Gallagher;

Dear Mr Goss,

We do not agree that there are any problems with the contractual terms proposed for the tender and there have been no changes to the tender process. The deadline for submissions under the tender will remain as midnight tonight. If you do not submit a tender by that date we may be unable to consider you for participation in the tender process which would mean you will not be recognised by us to provide treatment to our members funded by Bupa. From the 15th May 2009 the current basis on which you provide treatment to Bupa members will end. Whilst I would hope that you will now be able to submit a response to the tender I do appreciate this is a matter for you to decide."

The Terms and Conditions have been available to review for the past 4 weeks, we believe this has offered time to take independent advice if required.

The benchmark prices in the tender are based on recent claims for physiotherapy treatment. There is the opportunity to submit a proposal to Bupa and in establishing agreements we will consider a number of factors. Session averages and price are extremely important but so too is the clarity that contracts will provide (clearly agreed terms between Bupa and the clinician for physiotherapy services offered to our members) and all elements have value such as location, clinical specialties and evidence of service excellence.

We can confirm that any submission which is made by Bupa Wellness in relation to the tender is made on exactly the same basis as any comparable physiotherapy provider. Whilst the businesses of Bupa Insurance and Bupa Wellness may have links there is separate management involved. The involvement of Bupa Wellness in this tender has at all times been at arms length. The teams dealing with the Bupa Wellness proposal and the Bupa Insurance tender are managed separately and information has only been provided between the two on the basis it would be provided from Bupa Insurance to any other provider. Any bid from Bupa Wellness will be subject to the same consideration as any other provider.

With kind regards

Jane Gallagher
Physiotherapy Tender Team
Bupa, Thames Side House, Staines, Middlesex TW18 4TL

It's interesting that BUPA Wellness are still publishing on their websites that they charge £51 for a 30 min session, £73 for an initial assessment and £127 for an 'Opinion and Report'. I thought those were above what they believe to be industry standards or as they put it 'value for money'?

[fizzysmiles]

Hi, I have just signed up to the forum as I have been reading the threads for the last week or so. I am a sole practitioner, working from home and have been registered with BUPa for the last 19 years.
On careful consideration I have decided to boycott the tender but wondered whether it would be in my best interests to inform Jane Gallagher of my decision. Would what you advise??
Thank you all for your blogs and helping me to reach a decision x

[physiobob]

As for the 'Arms Length' between BUPA Insurance Sales and BUPA Wellness here's another interesting commentary

Paul, Well done for not being “bullied”. I’ve always disliked bullies personally. On the BUPA Wellness bit, whilst we all know it’s rubbish, if you wanted to cause any mischief you might want to clarify why this does not simply add up - the level of operational integration at a senior level e.g. The finance director is Mike Dugdale – one of his direct reports is the head of contracting who is doing the tender, and another of his direct reports is the financial controller for all the BUPA wellness activities. There is a similar level of integration at senior management level on the sales side also – they all report to Fiona Harris – insurance sales and wellness sales.

Enough said…enjoy your weekend, R

[physiobob]

Hi, I have just signed up to the forum as I have been reading the threads for the last week or so. I am a sole practitioner, working from home and have been registered with BUPa for the last 19 years.
On careful consideration I have decided to boycott the tender but wondered whether it would be in my best interests to inform Jane Gallagher of my decision. Would what you advise??
Thank you all for your blogs and helping me to reach a decision x

Many have informed her of their intention not to tender. There is an overview of some suggested copy for that a few threads above this one. Thanks for standing firm.

[physiobob]

Well midnight came and went and we're all still alive!