Dr Subashini M: Health insurers pull together

Dr Subashini M, Associate Medical Director, Aviva UK Health & Protection, explores the impact of Covid-19 on private healthcare accessibility.

Whilst the pandemic put significant pressure on our NHS, it coped the best it could. Non-urgent non-COVID- 19-related services were deprioritised to ensure that healthcare resources were pointed at the greatest public health challenge of this century. While initially this approach gave us comfort, concern grew when the public learned that many private beds remained empty during this time, with questions around why they couldn’t be used to support patients whose cancer diagnostics and treatments had been delayed. It is a perfectly reasonable question, and one which I can empathise with.

As a patient, we only see the care we get access to. A bed isn’t just a physical entity – it comes with a whole support team including HCAs, porters, doctors, nurses, laboratory technicians, drugs and critical care support. Throughout the initial peak of the pandemic, healthcare teams faced challenges – from availability of PPE to assessing whether they were fit for purpose, from accuracy of COVID- 19 testing kits to availability of lab staff to process the results.

At times, access to essential drugs and critical care staff were also limited. Where these issues were overcome, healthcare teams have had to make extremely difficult decisions regarding which patients to prioritise. When it comes to conditions such as cancer, whether it  is  chemotherapy,  surgery or diagnostics, everything must be lined up perfectly to enable the procedure to take place safely. Cancer treatment is a precise art requiring meticulous planning. There is no room for error. Just one missing piece of the “recipe” can severely compromise patient safety.

This is crucial as one of the key pillars of medical ethics is non-maleficence – do no harm. This ethos underpins all clinical decisions and this pandemic has added complexity to this decision-making process. Duty of care in this situation is not limited to the patient but also to healthcare staff.

Increased access to private medical insurance

When the initial peak of COVID-19 pandemic passed, the NHS started to restore some of its other services on a localised basis and the nationwide contract between the NHS and independent sector providers was scaled back. While a proportion of private sector resource currently remains available to support the NHS, many facilities introduced measures, such as extending opening times (including at weekends) to enable them to see patients expediently.

Throughout the pandemic, private medical insurance providers took a united stance through the Association of British Insurers (ABI) to support the response to the national challenge. In conjunction with the Independent Healthcare Providers Network (IHPN) and ABI, new processes and practices were introduced to help private medical insurance customers during this uncertain period. Private hospitals share weekly situation reports which help insurers to identify the services that are available and which consultants can see our customers.

At Aviva, we feed this information directly into our front-line systems so that our claims teams can help support and guide customers to relevant treatment providers, booking appointments for them where the functionality is available.

Our number one priority is customer safety. Through our “Aviva Assurance” process, we capture each provider’s COVID-19 operational processes to assure ourselves that appropriate protocols are being followed to provide treatment in a safe environment. We also fund a PCR test for customers who are about to undergo private medical treatment to test whether they have the virus, in order to protect them, other patients and healthcare workers. Our claims data for the last few months saw suppliers successfully adapting to the situation.

As expected, and in line with national guidelines, surgical treatments for non-urgent conditions such as orthopaedics, dropped significantly during the peak of the pandemic. However, claims for outpatient consultations and treatment remained buoyant as healthcare professionals adapted to providing care through video or telephone consultations. We also saw cancer services being reconfigured to offer care at home where appropriate and private hospitals repurposing areas within the hospital to help them to continue treating patients in a safe manner.

As we start to see COVID-19 cases increase again, the health sector faces a continued period of uncertainty. We’re proud of the way that the whole healthcare industry has adapted and pulled together during this time. We’ve proved that as an industry we can remain resilient in the face of a pandemic. And, by taking learnings from the first wave, we’re confident that we can do this again.

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