Leading medical reporting organisation (MRO) Doctors Chambers has become the latest ‘tier 1’ agency to create 10 ‘tier 2’ businesses to ensure a better flow of work through the MedCo portal, Litigation Futures can reveal.
It is following the lead of Speed Medical, with other tier 1 MROs – that is, national high-volume providers – expected to follow suit.
Doctors Chambers has two tier 1 agencies registered – the other is called Bodycare Clinics – and while chairman and CEO Dr Bippon Vinayak would not comment on the effect the new regime has had on his business, he said the move was because “the playing field is not level”.
As things stand, he explained, MROs were better off paying less to be in tier 2 (registration costs £75,000 for tier 1 and £15,000 for tier 2) because they appear more often in results, a situation he described as “not healthy”.
Users who choose to select an MRO are provided with a list of seven, of which only one is a tier 1 provider. An unexpectedly large number of companies have registered at tier 1 – in the absence of any official figures, it is said to be anywhere between 15 and 19 – meaning that the market share for tier 1 firms which previously dominated the supply of reports has fallen dramatically.
Such was the rush to get MedCo up and running before the election that MROs self-certified their eligibility to be in tier 1. MedCo is only now starting to audit them against the criteria, such as the capacity to process at least 40,000 instructions a year, national coverage and a minimum trading history of two years.
“I am hopeful that the audit process will be robust and correctly identify the companies that can provide the level of service required for that tier,” said Dr Vinayak.
He described the current state of MedCo as ‘version 0’, expressing hope that once the Ministry of Justice (MoJ) carries out its promised six-month review, it will introduce the necessary changes to create ‘version 1’, which he said is where it should have started.
There have been calls for more than one tier 1 MRO to show up in results and for them to be identified as such on screen.
Dr Vinayak said the rules underlying MedCo needed to be tightened up to “drive the right behaviours in the market”.
He said he hoped the creation of the tier 2 companies – which have still to be formally approved by MedCo – would only be a temporary measure until the regime is reformed.
Donald Fowler, group chief executive of tier 1 MRO Premex, would not be drawn on whether his company would also be registering tier 2 agencies, but said: “We are watching with interest and considering our next step given we want to avoid being at a market disadvantage.”
Asked about multiple registrations, a spokeswoman for MedCo said: “MedCo is registering all firms that have demonstrated they meet the qualifying criteria set out by the MoJ and provided evidence of such. As planned, MedCo will audit registered companies to encourage compliance. MedCo is unable to comment on individual registrations.
“The MedCo board recognises that this is a rapidly evolving market and that some behaviours, while currently permitted under the qualifying criteria as set out by the MoJ, may undermine the original policy intention. Processes may be updated in the future to address these concerns and users will be notified.
“The board is currently seeking urgent legal advice on the scope of its authority, within the legal framework set up by the MoJ, to address these emerging operational concerns. It remains for the MoJ to consider whether there is a case for adapting any aspect of the policy framework.”