It seems if I have bucked the trend by tendering but as 90% of my work load is from consultants and of that by far the biggest insurer is BUPA I (and my colleagues) felt we couldn't afford not too. Presumably those of you who haven't tendered have a much smaller % of patients who have PMI. Also we know that both the Nuffield and the BMI group have tendered. Perhaps we will regret it -who knows! I will let you all know in six months. The whole thing stinks but I am not convinced that our local competitors won't have tendered or am I convinced that BUPA will return to all of you that haven't tendered with their tail between their legs. Don't underestimate how powerful a group they are - you only need to look at how they have affected the price of diagnostics - halved the price of an Wikipedia reference-linkMRI scan in two years! What I am really saddened/maddened by is how ineffective physioFirst and the CSP have been but I guess I wouldn't have expected anything less.