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Bupa Health Insurance to establish first accredited network of ophthalmological units5 December 2006Bupa Health Insurance is establishing the first national hospital network of quality accredited ophthalmology services in the UK as part of its continuing commitment to raising the standards and improving the value of private health care for patients. Bupa has already established national accredited networks for cancer services (breast, bowel and gynaecology) and earlier in 2006 for MRI. All of these are designed to provide patients with confidence that their care will be of the highest clinical standards and at the same time, represent good value for money. "For the past decade we have undertaken a series of initiatives across a number of medical specialities to ensure our members can easily find high quality providers for their treatment. We know that good quality clinical care is also more cost effective and so, at the same time, these initiatives are also helping to make sure the services offer good value for money and that private care remains affordable for patients," said Dr Natalie-Jane Macdonald, Bupa Health Insurance’s medical director. Although private treatment standards are generally good, the insurer’s review of current eye services has revealed significant opportunities to further improve the standards and of private treatment with variation in the quality and cost of treatment. The review found that almost a quarter of facilities do not routinely monitor two important complications of cataract surgery. It also identified that clinical guidelines were sometimes not used by consultants and that there were weaknesses in monitoring of services and results for patients which are both important if services are to be continually improved. Only half of ophthalmologists currently use the Royal College of Ophthalmologists’ recommended outcome measurement guidance. There is also disparity in the total amount the insurer pays for a cataract operation in the private sector with a 300 percent difference between the lowest and highest costs. NHS Tariff for the same procedure is between £702 and £1,015. In some cases Bupa is asked to pay more than £3,500 for the operation in the private sector. The insurer pays for more than 20,000 ophthalmology treatments and 100,000 ophthalmology consultations every year. "All facilities where our members receive treatment and the consultants who treat them meet current Healthcare Commission and General Medical Council standards. However, it is worrying that there is such variation in clinical practice for no apparent reason." said Dr Macdonald. When compared to the national average, Bupa Health Insurance also found a significantly higher rate of in-patient stays than day cases for cataract operations. Nationally, more than 90 percent of cataract treatments are performed as day-case procedures yet only three quarters of Bupa members’ cataracts are treated as day cases. Almost 20 percent of Bupa members stay overnight with around five percent staying for two nights after cataract surgery. This means that patients may be spending more time in hospital than is necessary for them. Dr Macdonald said: "Our data shows a difference of more than 200 percent in consultants’ charges for cataracts across the UK which range from £480 to £1,670. It is right for us to ask why one consultant is more expensive than another and whether the higher prices charged are linked to better treatment and a better result for the patient. In some areas of medicine, if three quarters of consultants were to adopt the practice of the most efficient 25 percent, treatment costs could be reduced by almost a third. These savings could help to fund the latest cancer drugs and other cutting edge technologies for our members. "We expect hospitals and consultants to be able to demonstrate a link between their prices and the standards of treatment and experience patients receive. Cataract operations have become quicker and simpler over time as a result of advances in technology. An ophthalmologist could potentially do up to 10 cataract operations in one three and a half hour session whereas 15 years ago, one cataract operation may have taken an hour or more. "We want our members to have access to quality accredited ophthalmic services, wherever they live, and to give them confidence that their treatment will be of the highest standards," she said. In an independent survey, more than three quarters of consultants said they expect private medical insurers to take some responsibility for measuring and monitoring the effectiveness of specialists. Recent Bupa research revealed that:
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