Experience the difference - the NHS and private patient journey

Private medical cover gives us access to a completely different system of healthcare from the NHS - or does it? With the advent of Patient Choice in April 2009, NHS patients now have the option to have their hospital treatment in a facility of their choice. In some cases this treatment can be delivered in a private hospital alongside private patients who are paying for their care. In practice, Patient Choice is only being exercised by a small proportion of NHS patients (less than 5%). Reasons for this include problems with the technology, lack of General Practitioner (GP) buy-in and low awareness of the choice option amongst patients.

So what does this mean for private medical cover? Are the differences between NHS and private care clear?

The following diagram below shows the patient journey from three perspectives:

• NHS patient
• Private patient
• Cigna private patient.

This highlights the five main steps in the patient journey and compares these across the 3 perspectives. The NHS is undoubtedly the foundation of our healthcare system in the UK and through reforms it has made many efficiency improvements in recent years. But there are still limits in the NHS in terms of access to care and patient choice. As an example, an NHS patient may be referred to a private hospital for a consultation but they'll have to attend a group clinic where they are unlikely to be seen by a consultant. Then they'll have to meet stringent criteria to have access to some surgical procedures and must then wait a minimum of 14 weeks to have the treatment.

Once in hospital the different experience for an NHS and private patient continues. Private patients often have their own private room and services. Private healthcare also means more personal care. Consultations are based on individual appointments rather than clinics. Follow up care is one to one. And members of Cigna's medical plans enjoy an even better experience. Our nurses can provide advice and support throughout the patient journey. They can help patients get the information they need from their consultant, provide additional support through the Care Co-ordination Programme and continue to support the patient and their family in their recovery after treatment is completed.

So, what else do we do to make the difference for a patient going through this journey?

Cigna – enhancing the patient journey

Along this journey we help our members access all the benefits available to them. By helping to manage the patient journey we can really make a difference.

We believe that choice is at the cornerstone of private healthcare – and this means making sure patients receive the most appropriate treatment in the most appropriate setting. And without the restrictions that some of the new directional products in the market impose, particularly on consultant choice.

By allowing patients direct referral to diagnostics, treatment and recovery tools throughout their journey we are truly making the difference.

Let's take a closer look at our innovative approach to referrals within our wider approach to managing patient care.

Cigna – leading the way in innovation

We're always looking at ways to improve the patient experience for our members and their family. This means reviewing not only our plan design, but also considering how to facilitate quick and effective, but clinically appropriate, access to treatment. We know through experience that it can be a worrying and stressful time waiting to find out what's wrong. By continually reviewing and extending our referral pathways, we can reduce unnecessary delays.

• Back in 2007, the National Institute for Clinical Excellence (NICE) endorsed Cognitive Behavioural Therapy (CBT) as a very effective treatment for common mental health disorders e.g. mild to moderate anxiety and depression. Given this recognised best practice, we changed our medical plan cover to allow GPs and Occupation Health Physicians (OHP's) to directly refer those feeling the debilitating effects of anxiety and depression to a CBT practitioner.
• We allow GPs to directly refer our members for diagnostic tests and investigations, cutting out unnecessary waiting times to see a consultant and consultation costs. For instance, if a GP knows that their patient needs a CT scan, they no longer need this verified by a private consultant and can directly refer them straight for the test.
• Our most recent enhancement allows members to self refer for physiotherapy to our preferred providers Nuffield Health, while still allowing them the choice of referring to another physio via their GP if they prefer. Nuffield Health has identified the most suitable treatment for key conditions based on extensive clinical research. This means that members can be assured that they'll be getting the most suitable treatment for their condition without delay.

It's all about facilitating a quick and speedy recovery back to work with access to fast and evidence based treatment, while cutting out unnecessary expense.