Evidence that shows that there is a lack of patient benefit from knee arthroscopy for certain indications, such as chronic knee pain due to osteoarthritis. There is also a widely documented phenomenon of unwarranted variation in medical practice†.
Following a review of the rate of knee arthroscopy amongst Bupa insured customers, we found that it is several times higher than for adjusted comparison groups in NHS settings. We have also seen an unexplained wide variation in knee arthroscopies performed on our insured customers by different consultant orthopaedic surgeons.
Bupa has no shareholders and exists solely for the benefit of our customers. We have a duty to our customers to fund only clinically appropriate treatment and we want to work with doctors to ensure that this happens in every case. This is why we are introducing a medical review process. All knee arthroscopies performed on Bupa customers from 16 May 2011 must have gone through the medical review process to confirm eligibility for funding. Any knee arthroscopies that do not appear to meet published evidence-based guidelines‡ will be independently peer reviewed by a UK-based orthopaedic consultant. We therefore recommend that all knee arthroscopies are submitted for medical review before treatment is undertaken.
We will also be letting our insured customers know about the medical review process for knee arthroscopy.
A medical review form must be completed for every knee arthroscopy. Details of how to do this can be found on the form.
Alternatively you can download a PDF version of the medical review form and submit this to us by fax on 01784 893 255 or post to:
Bupa Arthroscopy Team, Willow House (Unit 3/4), Pinetrees, Chertsey Lane, Staines, Middlesex, TW18 3DZ
Please contact us if you have any further questions, by email at firstname.lastname@example.org or by calling 0345 755 3333 (lines are open from Monday to Friday: 8am to 6pm and on Saturday: 8am to 1pm).
† Unwarranted variation in medical practice:
- Wennberg JE. Time to tackle unwarranted variations in practice. BMJ 2011; 342. doi:10.1136/bmj.d1513
- Wennberg JE. Tracking Medicine: A Researcher’s Quest to Understand Health. Oxford University Press (2010). ISBN 9780199731787
- The Dartmouth Atlas of Health Care. www.dartmouthatlas.org, accessed 5 April 2-11
- QIPP/Right Care. The NHS Atlas of Variation in Healthcare. www.rightcare.nhs.uk/atlas, published November 2010