Trust to sue insurance giant, accusing it of 'immoral behaviour'

Ross Dunworth, finance director at Royal Surrey Foundation Trust, says Bupa is “behaving in an immoral way” when it comes to paying the trust for treating its patients within a specialist unit.

The dispute centres around the trust’s brachytherapy service, which treats private as well as NHS patients. Mr Dunworth, also deputy chief executive, says Bupa has refused to pay the full amounts owed, citing issues around coding of treatments.

In a statement, Bupa suggested it did not receive invoices from the trust within the contractual six-month period, and had received 65 historic invoices earlier this year which were “unexpected”.

Mr Dunworth disputed this, saying there had not been an issue with late invoicing. He told HSJ the company owes the trust around £400,000.

He added: “Consequently we have instructed our solicitors to take Bupa to court for the recovery of aged amounts due. We will also be writing to Bupa members who received subsidised treatment to explain why we are taking this action.

“Our consultants have been notified of this decision and that we will not be entering into a contract with Bupa at this time, but will work with NHS England to effect an NHS wide approach to contracting with Bupa. The trust is fully supported by our regulator [NHS England and NHS Improvement] in taking this action.

“In the meantime, the trust is still open to work constructively with Bupa to agree a less one-sided and restrictive contract that works for both Bupa and the NHS, as a model contract for trusts to use.

“Given the financial and elective challenge… it is in many NHS peoples’ view that Bupa [is] behaving in an immoral way.”

He said the contract with Bupa is restrictive because it prevents the trust from asking the individual private patients to pay the shortfall in costs.

It is understood NHSE officials have been involved in the discussions and actions at the trust.

John Crompton, head of hospital management at Bupa, said: “Bupa has had a good working relationship with Royal Surrey NHS Foundation Trust for more than 20 years. However earlier this year, the foundation trust sent Bupa 65 historic invoices, dating back as far as 2015.

“This was unexpected as our contract with the trust states that it will invoice us for its services within six months of providing them. This is common practice and we have worked together with Royal Surrey NHS Foundation Trust on this basis for the last 20 years.

“We are in the process of reviewing these invoices, and where valid these will be paid to the trust as quickly as possible. We have co-operated fully with the trust and are trying to resolve the issues raised.

“We value the relationships we have with all hospitals and clinics and ask all providers that we work with to invoice us within six months so we have an up-to-date picture of customers’ claims and can let our customers know about their available allowances in their current policy year. This also means we can calculate renewal prices fairly.”

HSJ asked Bupa, which says it has 31 million customers worldwide, to provide some data showing the frequency at which it disputes invoices from the NHS, but this was not answered.

NHSE said in a statement: “Any non-payment of services to NHS trusts is concerning and all necessary action will be taken to support trusts and ensure the NHS is paid for treatment.”