Clinical guidelines in the independent health care sector

Abstract

Eighty per cent of private health care bought in Britain is funded by insurance. To keep premiums low, insurers must contain costs, and one perceived mechanism is evidence based medicine. Some of the larger insurers are therefore introducing clinical practice guidelines into their business. BUPA, for example, has set up clinical consensus panels to develop professionally led guidelines that will “encourage the delivery of the very best health care…both in terms of appropriateness and quality of outcome.”2 The clinical guidelines being developed or in use cover mainly high cost, high volume elective surgery, which constitutes the bulk of private medical insurers' business, but psychiatric and medical guidelines …