www.independent-practitioner-today.co.uk
June 2020 Issue 122
INDEPENDENT PRACTITIONER TODAY
The business journal for doctors in private practice
In this issue
Ready for what comes next? Why mutual defence bodies are best Ensure your practice is in position The case against official plans for compulsory indemnity insurance P26
to take advantage of the release from lockdown. Tips on keeping the cash flowing P36
£12.50
NEW SERIES
Guide to delivering superior patient experience in private practice
n See page 22
Legal perils of Covid-19
A lawyer examines some of the legal issues you may be facing in the current climate and how to respond to them P38
Adapting to survive By Robin Stride
Private doctors are re-organising their fee structures and adapting to new ways of working as they struggle to stay afloat during the Covid19 crisis. Results of an online survey, by the London Consultants’ Assoc iation (LCA), reveal frustrated practice owners fear disaster as they have no work, zero income and mounting financial problems. Some are more upbeat, but others among the 238 specialists who responded to the questionnaire within five days said retirement was their only option. One in ten had applied for the Coronavirus Business Interruption loan, with just over a third having to furlough support staff. The L CA said doctor s had adapted the way they charged and consulted for their services with eight in ten invoicing for remote/ virtual consultations; 86% for consulting by phone, 11% for prescriptions outside consultations and 6% for queries needing an email or phone response. Self-pay fees are expected to rise. Only 5% currently invoiced for often time-lengthy participation in multidisciplinary team meetings. Eighty per cent had consulting room access restricted or withdrawn, with a similar number having restricted diagnostics access. In association with
Nine out of ten had booking and admission difficulties. Over half (55%) aim to increase remote working, 37% expect to work fewer hours/days, one in four are considering a different employment model and 3% will move to agency secretaries. The LCA reports in this issue: ‘The majority of the respondents feel unsupported by the private medical insurers, their defence provider, their hospital providers, Government and, in some cases, their NHS employers.’ Defence providers offered to cut premiums for only 30% of respondents. A further 38% of doctors had approached their provider to get a reduction. Private practice was disrupted for many as they backed national efforts, but restoring this to past levels will be challenging, the association reported, particularly for private practice full-timers. It said many consultants were seriously considering giving up private practice. But it would focus its activities on supporting them in offering high-quality care. For those continuing, operational changes will include more effective IT use for patient and business management, streamlining systems and reducing patient numbers to allow social distancing – meaning fewer patients per unit of time.
PLANNING NEEDED FOR A RESTART Private practice needs a ‘project restart’ with a co-ordinated response from all organisations supporting the consultant workforce who provide their income, according to LCA chairman Dr Mark Vanderpump. He said he was ‘cautiously optimistic’ things would slowly improve but it might take at least 12 months to fully recover. Data from other industries showed that a prolonged period of inactivity, as experienced in this lockdown, resulted in a slow return and recovery to previous activity levels, Dr Vanderpump (pictured right) warned. He expressed concern that the extent of the crisis in private medicine had not been recognised by all parties. Doctors’ high and fast response to the LCA survey was ‘a surprise’. They felt ‘badly let down’ by private medical insurers, defence bodies and their hospitals.
‘Private insurers may need to open private practice to groups previously not covered within their policies, such as those with chronic diseases and pre-existing conditions to stimulate the private health market. ‘More thought will be needed to support self-payers as the NHS waiting lists will inevitably rise significantly with the likely introduction of forms of healthcare rationing in a struggling economy.’ International patients would also need considerable support to be able to access consultants’ services.
Consultants anticipate working longer hours with lower income and do not expect to return to faceto-face consultations until frequent and reliable Covid-19 testing is available. But the LCA warned loss of confidence resulting from the pandemic
would continue to influence patient demand for some time to come. Now it urgently wants to know what actions can be explored to address the situation and speed up a staged return to normal care for private patients. n See pages 10 and 12