• Home
  • COVID-19
  • Life
  • Critical illness
  • Income protection
  • Health
  • Employee benefits
  • Regulation
  • Diversity
  • Mental health
  • Events
  • Industry Voice
  • Newsletters
  • Sign in
  •  
    •  

      Personalise your on site experience.


      Download and use the apps.


      Access your subscription from outside of the office.


      Get relevant news and insight straight to your inbox.

      • Sign in
     
      • Account details
      • Contact support
      • Sign out
     
  • Follow us
    • Twitter
    • LinkedIn
    • Newsletters
    • YouTube
    • Instagram
  • Register
  • Events
    • Upcoming events
      event logo
      Business as usual? Mental health and wellbeing in a post-pandemic era

      As we enter a new year, how is the health and protection insurance sector poised to support the mental health and wellbeing needs of individuals and employees? Taking place on Blue Monday (18 January 2021), this interactive online webinar in association with Aviva, featuring leading industry thinkers and mental health experts, will explore:-The evolution of healthcare in a post-pandemic world – where next? -The changing conversation around mental health & wellbeing and the role of prevention -The remote revolution: adapting to the ‘new normal’ and supporting the needs of individuals and employees

      • Date: 18 Jan 2021
      event logo
      Mental Health & Wellbeing 360
      • Date: 25 Mar 2021
      • Digital Conference,
      View all events
      Follow our events

      Sign up to receive email alerts about our events

      Sign up

  • Industry Voice
Cover Magazine
Cover Magazine
  • Home
  • COVID-19
  • Life
  • Critical illness
  • Income protection
  • Health
  • Employee benefits
  • Regulation
  • Diversity
  • Mental health
 
  •  

    Personalise your on site experience.


    Download and use the apps.


    Access your subscription from outside of the office.


    Get relevant news and insight straight to your inbox.

    • Sign in
 
    • Account details
    • Contact support
    • Sign out
 
  • PMI

Bupa defends open referrals after doctors' criticism

  • Owain Thomas
  • 11 January 2012
  • Tweet  
  • Facebook  
  • LinkedIn  
  • Send to  
0 Comments

Bupa has hit back at claims by doctors that its open referrals process is ‘flawed on several levels' and limits patient choice.

The insurer claimed recent findings by the Office of Fair Trading (OFT) supported its decision and revealed the majority of renewing corporate schemes were taking up the option.

It also noted that of more than 30,000 patients who used the process last year, 93% were comfortable with Bupa providing guidance and choice about hospitals and consultants.

Related articles

  • Supreme Court 'substantially' rules in favour of BI claimants
  • Suzy Esson joins Holloway Friendly exec team
  • MetLife launches simplified income protection policy
  • SME trust in insurers has slipped following Covid

The British Orthopaedic Association (BOA) has previously clashed with the private medical insurance (PMI) provider over its use of reviews for certain types of knee surgery.

However, in an open letter on its website, the BOA's Patient Liaison Group said it was ‘deeply concerned by Bupa's introduction of an open referral system' for corporate schemes.

‘It seems to us that the rationale given by Bupa is flawed on several levels because of the apparent lack of patency and the references to unpublished and unsubstantiated data,' it said.

‘In our view, there is no justification for the schism being driven between the patient and their GP; further, the implication that a GP may not know the local specialists, or what is best for the patient, is disingenuous.'

The Group also contended this was in contrast to NHS policy which intended to offer greater choice and questioned whether the desired effect of reducing those patients having to pay top-up would be reversed because any Bupa options might be too inconvenient.

However, it did accept that some patients may prefer guidance from their insurer but queried if this should be extended to all.

The letter concluded by saying Bupa should instead make it clear that every client has the option of either going to an ‘approved' clinician, or paying extra to go to one whose charges are outside the Bupa tariff.

It added there was a ‘risk of undue interference in the patient-GP relationship and that ultimately, the system may serve to limit patient choice'.

In response, Bupa said its clients were happy with the process and wanted to ensure patients would not have to pay any shortfalls for their treatment.

Katrina Herren, medical director at Bupa Health and Wellbeing, also cited the OFT's findings from its review of the private healthcare market as support for the policy.

"Recent research carried out for the OFT shows GPs often have limited information about a consultant's care practices, outcomes, patient experience, private patient charges or end-to-end costs of care," she said.

"This means that when our members need specialist care, they are often referred by their GP to a consultant based on ‘informal' information, and sometimes experience unexpected top-up fees from the consultant because they charge outside of Bupa's monetary limits.

"Open referrals offer increased choice for our members - rather than being referred to a single consultant by a GP, we provide our members with a choice of two or more consultants offering appropriate care at convenient locations.

"And if a GP feels that their patient should see a particular consultant, we are happy to discuss this; however our experience has shown that this happens very rarely," she added.

Herren also noted that additional or unexpected fees for treatment was one of the biggest causes of customer complaints and said the consultants that it used have an excellent record of treating Bupa members.

  • Tweet  
  • Facebook  
  • LinkedIn  
  • Send to  
  • Topics
  • PMI
  • PMI/Private Medical Insurance
  • healthcare
  • Bupa
  • Office of Fair Trading
  • OFT

More on PMI

Rob Stevenson is founder of InsideOut LeaderBoard
COVER Webinar this Monday… Who are our speakers?

‘Business as usual? Mental health and wellbeing in a post-pandemic era’ takes place on Monday

  • Group Protection
  • 15 January 2021
Register your free place for COVER Mental Health & Wellbeing 360

Prevention during a pandemic

  • Group Protection
  • 12 January 2021
Will Wood has been appointed head of life and health for INSTANDA
INSTANDA expands life and health focus with ex-Aviva hire

Will Wood, previously head of UK SME strategy at Aviva, has joined insurtech firm

  • Group Protection
  • 12 January 2021
Millions of teens suffering mentally and physically during pandemic

Three in four

  • PMI
  • 08 January 2021
Five New Year's resolutions for insurers to consider in 2021

‘Prevention is better than cure’

  • Individual Protection
  • 08 January 2021
blog comments powered by Disqus
Back to Top

Most read

Critical illness: Seven areas to keep an eye on
Critical illness: Seven areas to keep an eye on
DeadHappy to go 'mainstream' following £4.75m investment
DeadHappy to go 'mainstream' following £4.75m investment
MetLife launches simplified income protection policy
MetLife launches simplified income protection policy
The 'big five' benefits trends for 2021
The 'big five' benefits trends for 2021
Rob Clarkson joins Neilson Group as non-exec director
Rob Clarkson joins Neilson Group as non-exec director
  • Contact Us
  • Marketing services
  • About Incisive Media
  • Terms and conditions
  • Policies
  • Careers
  • Twitter
  • LinkedIn
  • Newsletters
  • YouTube
  • Instagram

© Incisive Business Media (IP) Limited, Published by Incisive Business Media Limited, New London House, 172 Drury Lane, London WC2B 5QR, registered in England and Wales with company registration numbers 09177174 & 09178013

Digital publisher of the year
Digital publisher of the year 2010, 2013, 2016 & 2017
Loading