Should You Offer Video Consultations in Your Physio Practice?

If you treat Bupa patients remotely, their contract requires a direct peer-to-peer connection with no retention of audio or video, no in-consultation text chat, and both parties physically in the UK. That rules out how most clinics currently use Zoom or Teams.

Almost every article on this topic argues about whether video physiotherapy works. That question is largely settled and it is not what stops practices. What stops them is discovering, after they have built the service, that their insurer or their indemnity does not permit the way they built it.

What does Bupa actually require?

Bupa's published physiotherapy contract carries a set of quality standards for remote physiotherapy, and the requirements are unusually specific.

A direct connection between the two people. The contract says you and the member should use software on your respective devices, known as peer to peer, to connect directly, rather than hosting the session online through a third party who is likely to record the conversation.

No retention of stream data, audio or video or both.

No in-consultation text chat. The contract advises avoiding it, on the basis that text conversation may well be stored either locally or remotely.

Secure network. WPA-2 as a minimum, and a prohibition on public or coffee-shop Wi-Fi.

Both parties in the UK, physically, at the time of the consultation.

Locate the patient. You must ask where the member is, so that you can call emergency services if needed. That one is easy to skip and is a genuine safety requirement, not a formality.

Does that rule out Zoom or Teams?

In their default configurations, effectively yes.

Both are hosted services that route the session through the provider's infrastructure rather than connecting the two devices directly, and both have features that retain or can retain content. That is precisely the arrangement the standard describes as the thing to avoid.

That does not mean no mainstream tool can be configured acceptably. It means the configuration matters, the default is not compliant, and "we use Teams" is not an answer to the question the contract asks.

If you take Bupa work, get the specifics in writing from Bupa before you commit to a platform. If you do not, the standard is still a reasonable benchmark for what good looks like.

What does your indemnity say?

The second constraint, and the one that catches practitioners who never touch insurer work.

CSP professional liability covers telemedicine for members based in the UK treating patients in the UK, and patients based overseas except in Australia, the USA and Canada. It also does not extend to any country where telemedicine is subject to local regulation.

That last clause deserves attention because it is self-adjusting. If the country your patient is in regulates telehealth, the cover may fall away precisely where the regulatory risk is highest.

Two practical consequences.

A patient on holiday abroad is a question, not an assumption. Some policies are drafted around where the patient physically is at the time of the session rather than where they live.

A patient who emigrates is a different arrangement. Continuing with them as though nothing has changed is where practices get into trouble.

Check your own policy wording, and ask about specific countries rather than in general.

So is it worth offering?

Yes, for the right things, and the honest answer is that it is a complement rather than a substitute.

It works well for follow-up and progression of an exercise programme, education and reassurance, triage before a first appointment, reviewing a home or workstation setup, and continuity when a patient cannot travel.

It works badly for anything requiring hands-on assessment or treatment, first appointments where you need to examine, and any presentation where you are seriously considering red flags.

The commercial case is usually about capacity and retention rather than new revenue. A follow-up that would otherwise be cancelled because of a work commitment becomes a session that happens. That protects the course of treatment, which is where the money in private practice actually sits, as our guide to what a physiotherapy session should cost sets out.

What you need in place before you start

A platform that meets the standard you are held to, checked rather than assumed
Written confirmation from any insurer whose patients you will see remotely
Your indemnity position confirmed, including geography
A location question at the start of every remote session, recorded
Consent to remote consultation, recorded, covering its limitations
A red flag protocol, because you cannot examine and you need a clear rule for converting to in-person or referring on

Point five matters more than it sounds. A patient consenting to physiotherapy has not necessarily consented to receiving it by video, and the limitations of remote assessment are material information.

Where we are on this ourselves

Since this is our own guide, it would be poor form not to say where Atlacare stands.

Video consultations are not finished in Atlacare. The provider integration and the room model are built, but the join flow, telehealth consent and the patient-facing emails are not, and video is not switched on for clinics. Do not choose us for telehealth today.

What we do have that is relevant is the surrounding record: appointments marked as video, clinical notes locked and versioned on sign off, consent forms attached to the patient record, and the patient portal. If and when you run remote sessions, that is where the evidence of what was agreed and what was delivered should live, whichever platform carries the call.

The short version

The clinical question is the easy one. Video works for follow-up, education and triage, and not for hands-on work.

The questions that actually determine whether you can offer it are contractual and geographic: what your insurer requires of the connection, and where your indemnity stops. Both are answerable in an afternoon, and both are considerably cheaper to answer before you build the service than after.

This is general information, not legal or contractual advice. Insurer requirements and indemnity terms change and vary between providers. Confirm the current position in writing with Bupa, your other insurers and your indemnity provider before offering remote consultations.

Sources: Bupa physiotherapy provider contract · CSP, digital and virtual physiotherapy insurance · CSP, remote consultations