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

[hockeyphys]

Oh dear. This is sounding rather 'clubby' vis a vis the London based practitioners. Where does that leave the rest of us, North of the Watford Gap?

After all, only 25 votes on the 'who did and who didn't poll' on this site is hardly a substantive reflection, unlike the one on 'The Physios Voice', which basically shows a one third/two third split in favour of not tendering.

How this all will reflect across the Country remains to be seen, as does how BUPA will react, but I am beginning to sense that those contributing here are mostly 'inner City' and, as such, not a reasonable representation of Country wide opinion.

Looking back on the individual posts again, I don't think this is so- it's predomiantly South yes, but a high distribution from around the country. -However the most vociforous posts are the London ones. It also seems that the London clinics had little to loose (Unless they were seriously overcharging!) as BUPA seemed to quote a fair rate for them - it was the 'rest of the country' rates that were a pittance
However, I think it does show a division between the 'big business' polyclinics, who are trying to corner the market, and those running, single,(large and small) clinics or working on thier own, and are happy to work alongside their competitors in the area. ( I may be wrong on that- it's just a feeling.) THe fact that BUPA had an 'if you have more than 10 clinics contact us directly' clause in the tender makes me feel that they did invite such clinics to discuss terms outside these tender restrictions.
I would hate to think that we may have been manipulated by this process, but it's starting to feel a bit like that - it will become obvious to all after May 15th what actually happened!
I would hope that when this has settled we would all continue to meet as local groups and all work towards the same aim of high quality treatments at a reasonable cost, but in meeting face to face so we can tell who's behaving honestly and who's not.
We should also lobby the CSP and PF more to act a better on our behalf - as a neutral party they are in the best position to do this - but this whole incident shows that they only start to act when pushed - I guess this means reading and responding more to what's in the journals (but sometimes it's sooo hard to get the plastic cover off!)
I know PF are very disapointed in the lack of feedback for the data collection survey ( which if collated would give us much more power to our elbow) - but to do it is a very longwinded and time consuming process that many of us don't have time for - has anyone gone back to them to see if it can be made easier?

[scottish physio]

Oh dear. This is sounding rather 'clubby' vis a vis the London based practitioners. Where does that leave the rest of us, North of the Watford Gap?

After all, only 25 votes on the 'who did and who didn't poll' on this site is hardly a substantive reflection, unlike the one on 'The Physios Voice', which basically shows a one third/two third split in favour of not tendering.

How this all will reflect across the Country remains to be seen, as does how BUPA will react, but I am beginning to sense that those contributing here are mostly 'inner City' and, as such, not a reasonable representation of Country wide opinion.

It is very difficult to gauge what went on in Scotland.
I didn't tender and know of one other practice that didn't. I know of 2 sole practitioners who did. I'm on a course next week and will maybe hear more there.
I agree that it's gone very quiet but I guess it is a waiting game and only time will tell how many physios took part in the process.
I think most of us have had a big wake up call and need to get ourselves more organised and find a stronger voice for physios in private practice. I actually feel very depressed by Physiofirst and CSP. In my darker moments I was wondering if I could possibly re name myself a Rehabilitation Therapist. In this way I save myself 2 lots of annual fees and scores of paper work. I can just get on with the job of being a good therapist which is all I really want to be.

[londonphysio]

I don't think this blog is 'clubby' at all. I think there may be additional threats from big business in central London which may not be apparent elsewhere, but otherwise we have some similar concerns. In fact, I imagine that i hugely disagree with some of the london physios who have posted here and have more in common with some of those outside.
I would imagine that the decisions in BUPA will be made than more than one person, too. But that there will be a few rumours before the final results are known, and understandable panic from those who have a large exposure to BUPA.

[physiobob]

I also do not feel that this thread is 'Clubby'. The only thing to consider is to thank all the London based physio's that they got together at an early stage to confront the issues and take the CSP and PF to hand over the real threat to the profession -to force them to address the bigger picture. And they have put their hands in their pockets as well. This is not to say that there were and are many, many outside of London physio's who also travelled into London for the meeting. Also many others who emailed that due to the distance they could not attend but wished to support the general consensus. And many have held similar meetings in their local areas. The tone of this thread and that on tpv has been one of unity, nationwide discussion and consensus as to why you might or (unfortunately) why you might not tender.

So let's not be distracted by diversional comments like one a few posts above this one.

Very few london practices are poly clinics. Most are smaller sole practitioner clinics and perhaps more so than anyone else in the country. But yes London based practices have high overheads and don't charge relatively more than the rest of the country. It is far more profitable with less risk and less fixed cost to be a physio outside of London. So let's stop with all the crap commentary that London based physio's charge a fortune and make lots of ££. It simply is not true and is totally misinformed.

As a London based practitioner my fees (which are pretty typical of the local area) are the bear minimum I can charge to bother staying in practice. To have any PMI challenge those and suggest I should charge less will make me shout. This is why London has shouted. It affects us most due to our larger fixed costs. And perhaps more than the money issue, most of the anger is also about clinical autonomy and the right to treat how we see fit and to charge what we think we're worth.

As this thread has stated many, many times - This is an issue for the physiotherapy profession in the UK. This is not about private practice. It is not about London. It is about physio students, students of the future, the future of the NHS blah blah blah. The sooner everyone takes that on board the better. If you get it, please explain it to those that don't.

And for the record those that have tendered, by and large have done so because they would be bankrupt it it succeeded and they missed out. And I think perhaps if you regionalise that you might find that is London centric as well.

[Mr Manipulator]

Have look and listen to this!:-

Insurance Drives Physical Therapists out of Business

[physiobob]

It's interesting to look at the results of the PhysioFirst survey.

http://www.surveymonkey.com

Looks from those results that a lot of people who responded were people who did fill out the tender process, at least in part. This should not be taken as actually filing an official tender as we know of many who did it and did not expect to get a result as they asked for what we are worth.

I suppose the results are a bit off in a few respects, or at least one should consider them in relation to:

This is a sub group who bothered to take part in both the tender and the survey. (That said it is a good number)

The London numbers responding to this survey are low. The results on the (also perhaps biased) Physio Forum and Physiosvoice showed similarly that about 80% of London based physios did NOT tender.

The split in the tender fee was about 50:50 for those who tendered at the BUPA suggested fee and those that tendered above. This is rather interesting as the fees are perhaps OK for people outside of the main cities. So the large number who tendered above the suggested fee actually suggests that the BUPA fee is not enough no matter where you are and therefore a London and Non-London pricing structure might not have been a sufficient differential.

48% more respondants indicated that set their fees for treatment above the BUPA benchmark. (35% at BUPA price vs 52.7% above BUPA suggested price)

More than half did not agree to their 2.5% increase after 2 yrs.

As you can see one should be careful in interpreting the simple display of these results.

The stats also does not include non-members of physiofirst who work in the private practice sector who might have been asked to tender.

[hockeyphys]

Interesting stats - different bias from the physio voice polls.
Having difficulty accessing this pol to regiter my response - how do you do it?
Seems to me that the demographic of who tendered does not register where the 'non tender' group are based, as if you didn't tender, you go straight to 'done'
As such I presume this is not a true reflective pole.
However, it is disapointing to see the proportion who tendered at or below the BUPA benchmark, and affectivly capitulated. Those voices have been very quiet on thsese sites - seems to me that there have been 2 voices - don't tender, or tender at your normal fees - seems that there's a whole group out there doing something else who should feel ashamed of themselves.

[physiobob]

Seems to me that the demographic of who tendered does not register where the 'non tender' group are based, as if you didn't tender, you go straight to 'done'
As such I presume this is not a true reflective pole.

Good point. PhysioFirst really should make some comment when they present some stats. Without that stats are likely to be misread.

[edgertonman]

Well we all wait with baited breath for the outcome (audited?) of the big issue. Just as a small thought we were told at the start of all this exercise that Bupa intended to ask 6000 of the 13000 physios on their books to tender .Have I missed something ? who are the non tendering physios . Are Bupa waiting to see if they have enough physios to provide a Liddle type service or have they quietly already reinstated those they wish to use ?
Any thoughts?

[physiobob]

Saw this on the BUPA website today. Interesting. Seems they are trying to get enough from their existing relationships. Then if that doesn't hold they'll open it up further down the chain. The chain I believe that for the past 4-5 years they have felt not sufficiently qualified to treat their clients. Seems when there's a need and a financial incentive any physio is OK to treat their clients. Maybe this is a question the OFT should be asking them of their 5yr+ minimum requirement.

We have decided to put on hold the recognition of new physiotherapists during this period but we will be able to get back to you after 1 October 2009 to update you on possible changes to the recognition process.

[physiosteo]

I tendered at a price above my normal price.
Just received this email from Bupa:

“As part of the second phase of implementation we will be contacting additional providers, including yourself, who we feel are able to enhance the network for the benefit of our members. We would like to better understand your current position and discuss your application further”

I guess that's a "no" for now, then?!

[hockeyphys]

Could you add the link so that all can see the whole BUPA quote (this site won't allow me to do that.)
Seems that we won't know tomorrow if we are 'in or out'
I presume that BUPA will now start to contact those of us who have tenderered at our full rates and try to get us to drop them.
We must stand firm on our quotes - we all put a lot of effort and thought into deciding what was right for us and our profession.
(Interesting that their site is down for'maintenance' all this weekend!)

[physiosteo]

no link, it was an email but i am happy to quote the whole thing:

I am writing further to your application for the Bupa UKM Approved Physiotherapy Network.

The response from physiotherapists was

extremely pleasing

and we received a total of 3,400 bids from clinics and or practices.

We have decided to phase the implementation of the network over the next few weeks, with the first phase starting on Friday 15 May covering an initial 3000 clinics and practices. We will be writing to all those clinics and practices that have been successful in gaining a place on the new Bupa approved network in readiness for the first phase of the launch.

As part of the second phase of implementation we will be contacting additional providers, including yourself, who we feel are able to enhance the network for the benefit of our members. We would like to better understand your current position and discuss your application further.

During the roll-out of the network, we are keen to ensure that our members still continue to receive a high level of service and care. Therefore, all recognised physiotherapists will continue to be eligible to treat their Bupa patients until we begin to formally suspend those providers with whom we have not reached a suitable agreement. Should you be unsuccessful, we will agree a period of time to ensure any ongoing treatment of Bupa members is completed to ensure continuity of care.

We would like to take this opportunity to acknowledge the feedback we have received to date from providers. We believe that by phasing the implementation of the full network, it will allow further valuable discussions to take place to the benefit of our members by increasing patient choice.

We will be communicating with you in the next few weeks to provide an update on the full launch of the network. Should you have any queries or require more information, please do not hesitate to call us on 0845 600 4078 or email physiotender@bupa.com.

With kind regards

Jane Gallagher
Commissioning Manager

[londonphysio]

Looks like they will definitely have their network, then. I hope that those who tendered below will not have been hedging their bets on an increase of referrals!
I am very nervous now, i have to confess. No access to my work email until the morning.
No BUPA for me means end of business.
Good luck everyone

[hockeyphys]

Don't neccessearily think that or panic! If you look through the whole thread of what was posted on thier BUPA site, (That is the thread I can't attach to this blog) I think it implys that they havn't got enough 'cheap' reponses to support their network.
The timing of Osteophysios reponse shows that JG has thrown out a blanket reponse after most closing hours - I'm sure many of us will wake up in the morning and see the same response - so hold on in there - this isn't finished yet!

[physiobob]

Yep and they are not saying anything about what tenders were fully complete or what were acceptable. I would suggest most have not come within their requirements. As such they are using a blanket number for you to think they already have their 3,000 when in fact they might only have a few 100. That is a scare tactic.

As said above you should stick to your guns, or even pull your tender. They have tried to divide and conquer, now they will tackle individuals. Let's just say by their wording they DO NOT have their network and they are now trying to work on plugging the gaps. In terms of negotiation that means anyone they contact is in the driving seat.

Of course I am still firmly behind the status of NOT tendering as it is both to the detriment of the public and the profession. Those that have, have indeed weakened the professions autonomy and have weakened any legal complaints we have to make. Stand firm!

[Bupa Physio tender team]

Bupa’s response to online discussions

During the tender process Bupa provided both a call centre and an email address to deal with queries from physiotherapists, as we believed this was the most appropriate way to answer all queries raised during the tender. Over the period of the tender Bupa responded to over 2000 calls and more than 800 emails, therefore I feel that we have given sufficient additional information to assist physiotherapists during this time.

Having howeverread with interest the various comments posted on The Physio’s Voice/The Physio Forum I thought it might be helpful to respond to some of the key points raised on the forum, correct one or two inaccuracies and answer some of the questions raised.

It is understandable that some physiotherapists are concerned about the Bupa tender. Many physiotherapists have contacted Bupa for clarity because they are confused by some of the information they have received from their professional organisations or colleagues – I’d like to reassure all practitioners that we want to work with physiotherapists so that together, we can make sure that patients receive quality assured treatment from a wide choice of physiotherapists.

Clinical autonomy: we do not want to interfere in clinical decision-making or threaten clinical autonomy. We are keen to understand the reasons for both the clinical and financial variation that currently exist and we appreciate that clinicians often treat a wide variety of conditions, some more complex than others, and that there may be valid clinical reasons for such variation. This is why the tender requested providers to develop evidence based treatment plans and share audit data that supports clinical outcomes.

Choice of practitioners: we are not trying to reduce the choice of physiotherapists for Bupa members and there has never been a desire to cap the number of preferred physiotherapy providers with whom we wish to contract. Bupa has not done a ‘U’ turn as described in various physiotherapy publications. We hope that many or all of those providers who submitted a tender will be able to agree contracts with us and join our new network.

Treatment costs: Bupa’s agreement with physiotherapists will be for the reimbursement of treatment costs including an initial and follow-on sessions. The only exception is where the clinician is offering a service that is not refundable under the terms of the patient’s Bupa insurance cover, for example a Pilates class or loan of equipment such as a TENS machine.

We invited clinicians to submit the fees they would charge if they were accepted into the network for the level of service they agreed to provide our members. We want to ensure that the rates our members pay are fair and reasonable. The benchmark prices in the tender are based on recent claims for physiotherapy treatment. In establishing agreements with physiotherapists, a number of factors will be considered: session averages and price are important, as are location, clinical specialties and evidence of service excellence.

Financial savings: By ensuring Bupa members receive quality assured value for money out-patient treatment, our customers are more likely to have the funds available when they need the reassurance of prompt access to care.
Any savings generated by the physiotherapy tender and other similar initiatives will be used to help fund health care for our customers

Clinical practice information: by requesting physiotherapists share information about their clinical practice and rates, we will be able to re-assure Bupa insured patients that a Bupa recognised physiotherapist will provide them with quality assured treatment and value for money; this is information which our customers are increasingly asking clinicians to provide.

Five years’ experience: our customers want the reassurance that the clinicians who treat them are experienced and able to offer specialist skills, hence we do not recognise newly qualified graduates. This applies to all medical practitioners recognised by Bupa Health Insurance, not just physiotherapists. It also applies to practitioners working in Bupa Wellness clinics who are subject to the same criterion. It would not be appropriate to assess the CV’s of all physiotherapists applying for recognition. Bupa realise that there may be clinicians of less than 5 years offering senior skills but to ensure a fair process we have decided not to make exceptions to this criterion.

Legal queries: PhysioFirst and the CSP recognise that it’s entirely appropriate for Bupa to regularly review the services provided to our members. However, they did have some concerns about our approach and have sought legal advice about the tender. Bupa has responded fully to lawyers acting for the professional bodies to all requests for information.

Claims processing: Bupa is not asking providers to process any claims or act on behalf of Bupa. We are asking that all network providers agree to invoice the cost of physiotherapy treatment direct to Bupa and not to request payment from our members. This is because we want our members to concentrate on getting better without the additional worry and hassle of having to pay for treatment and claim it back from Bupa afterwards. In addition to assist the provider with payment we ask that they check the pre-authorisation details with the member to ensure bills are paid.

Next Steps: the online tender is now closed and we are delighted with the response from physiotherapists. We are now reviewing the submissions and finalising the network. The network will be rolled out over the coming weeks.

If anyone has any concerns or questions about the Bupa physiotherapy tender, they can contact our team on 0845 600 4078 or email physiotender@bupa.com.
Mr Steven Pink
Head of Provider Relations and Procurement
Bupa UK Membership

[londonphysio]

So, what does the email above mean? There are lots of people who have received this email. Does it mean yes or no?
We who tendered have been waiting for this with a lot of concern, only to find out today that, well, it might be a yes but you may have to drop your fees first?
Can you tell us what the criterion for inclusion has been when I know my fees and sessional averagesare below those of my local bupa wellness clinic and I have signed up to all of the quality control issues mentioned in the tender?

[rangimarie]

Just received an acceptance letter from BUPA. Thought people might like to know what it says.

"Dear X,

Re.: Bupa UKM Approved Physiotherapy Network Announcement

Thank you for taking part in the Bupa UKM Physiotherapy tender. I am delighted to confirm that your bid was successful and, from 15 May 2009, your clinic/practice will become a Bupa Approved Provider of Physiotherapy services.

We are extremely pleased with the positive response we have received from physiotherapists and have generally found that, like you, most practitioners and practices are committed to the core values which underpin the network; namely, continuing to demonstrate clinical excellence, to deliver greater consistency, to provide customer service excellence, and to offer value for money."

... blah blah blah. It goes on.

Best of luck to everyone else waiting to hear. FYI, I tendered at my normal prices.

[londonphysio]

rangimari are your prices within the benchmark fees?

[rangimarie]

rangimari are your prices within the benchmark fees?

No, they are higher, by more than 25%.

[Chartered Physiotherapist]

Well, Bupa appears to have divided us. Those that successfully tendered, those that failed with their tender and those that didn't tender. Each group will now have their own cause for concern about the future.

Surely now AXAPPP will start to check the new Bupa Network Provider List to ensure parity. How could you justify charging different rates for BUPA and AXAPP patients? This is the tip of the iceberg in my opinion.

[physio4u]

I just wonder if there is any attempt by the insurance companies to set prices won't that amount to price fixing which I thought was illegal. Surely the rules about competition apply equally to the insurers as they do to us??

pt4u

[physiowestlondon]

Just got my contract back from Bupa, signed, and at prices slightly above their 'benchmarked' prices. It's been a bit of a roller coater ride, but I'm happy with the outcome. I didn't even have to drop my standard price - so all good!

[Mr Manipulator]

'Good' on the price side but let's not forget the terms and conditions to which all who tendered had to agree and which, despite what BUPA say, have serious implications for our professional autonomy in the future.