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OPEN REFERRAL
SCHEMES

Open Referral helps members find the right consultant for their clinical needs to ensure they get access to high quality treatment and care. Members will usually be given a choice of two or three consultants.

Why has Bupa introduced Open Referral?

We introduced Open Referral to address a number of key issues:

  • variation in clinical practice between consultants
  • shortfalls on claims - one of the biggest areas of customer complaint
  • unsustainable medical inflation - needs to be controlled in order to keep private healthcare affordable and accessible

Our promise

When a member follows Open Referral and pre-authorises all consultations and treatment, we will find the right consultant for their clinical need to ensure they get access to high quality treatment and care. We guarantee no additional surgical or anaesthetists costs for members on Open Referral schemes.

Benefits of Open Referral

Quality treatment is our top priority

Traditionally, a GP refers patients for treatment to a specific hospital or consultant. Independent research from The King’s Fund and the Office of Fair Trading shows that GPs do not generally have access to objective data about the quality or cost of care or consultants’ practices and facilities. Bupa developed open referral following analysis of extensive information including:

  • whether consultants are using the latest proven surgical techniques to treat Bupa members
  • the level of member feedback received about individual consultants
  • how treatment provided by a consultant compares to other consultants treating the same conditions
  • the overall cost of treatment from initial consultation through to discharge
  • how many procedures a consultant has performed

JUST

7%^

of GPs saw their role as making a definite recommendation for a particular choice of facility and / or consultant.

Consultant quality

All Bupa recognised consultants, including those available under Open Referral, have at least seven years experience in their medical speciality and are experts in their field. In fact, the average age and experience of Bupa fee-assured consultants is the same as Bupa recognised consultants who are not fee-assured. Consultants are regularly reviewed to ensure they meet Bupa’s high quality standards.

15%~

greater satisfaction amongst those personal members who received help choosing their consultant than those who did not.

An informed choice

As well as giving members informed choice, Open Referral ensures they will only be referred to consultants who won’t send members bills following treatment. This helps members avoid receiving unexpected additional costs from consultants and anaesthetists and gives greater peace of mind when they are being treated.

Make an Open Referral claim

More information

Download an Open Referral form (PDF, 41kb) and letter for your GP (PDF, 186kb)

General Open Referral frequently asked questions

Read our frequently asked questions

* Calls may be recorded and may be monitored.
^ Office of Fair Trading (OFT) Consultant and GP Survey 2011.
~ Members Choices Customer Satisfaction, Ipsos Mori April 2012.

Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales No. 3956433. Bupa Insurance Services Limited. Registered in England and Wales No. 3829851. Bupa Insurance limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Bupa Insurance Services Limited is authorised and regulated by the Financial Conduct Authority. Registered office: Bupa House, 15-19 Bloomsbury Way, London WC1A 2BA.

To make a claim

Personal scheme members
0845 609 0111*
Lines are open 8am to 8pm Monday to Friday and 8am to 6pm on Saturday.

Business scheme members
0845 609 0444*
Lines are open 8am to 8pm Monday to Friday and 8am to 1pm on Saturday.

Useful documents

Download customer actions pdf Open Referral FAQs
(PDF, 289kb)

Download customer actions pdf Open Referral form
(PDF, 41kb)

Download customer actions pdf Open Referral
GP letter

(PDF, 186kb)