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Sunday, 29 May 2016

Medical concierges: The smart new way to tackle illness

It’s a bewildering, scary time when you’re seriously ill, which is why a new breed of healthcare companies aim to take you by the hand and lead you through the maze of diagnostics, specialists and treatments.
‘I didn’t know anything about cancer (who wants to?) but when you get it you have to suddenly become an expert. And frankly, I didn’t know where to start,’ says Sarah.

Now, Sarah, 50 and from Solihull, knows more about cancer than most: she’s had it seven times over the past 11 years. Four years ago she decided to try something other than the treatment she was being offered. Google came up with ‘bad news and bad ideas’, until she found a company called Harley Street Cancer Concierge
‘As soon as I called them I felt positive,’ she says now. ‘They found a specialist who recommended a more targeted form of chemotherapy. For the first time in a long time, I started to focus on living with this disease, not worrying about dying from it.’
Sarah is one of an increasing number of people discovering a growth sector: medical middle men or ‘health concierges’, who organise appointments, give telephone support, audit bills and find what they consider to be the best specialists and treatment.
Right now, the UK market for health concierges is small, exclusive, very London-focused and self-regulated. Until recently there were only a couple of such services, both based in Harley Street, but in the past few months at least two new ones have opened.

Meanwhile, companies including investment banks have started employing concierges to help workers suffering serious illnesses, and experts are predicting that private medical insurers may soon integrate them too.

These concierge services originated in the US. Some specialise solely in organising second opinions; others, like The Health Concierge, a service for residents of a group of exclusive London developments, help match clients with a suitable GP, physiotherapist, paediatrician and so on.
Top-of-the-range companies include Harley Street’s Viavi, its new offshoot company Sanabilis, and Harley Street Cancer Concierge. At their most basic, they book appointments or find specialists; at the next level up, they can get you a second opinion on a path of treatment or diagnosis suggested by the NHS (this costs a few hundred pounds).
They can also search the world to find a clinical trial or specialist for complex cases. And Harley Street Cancer Concierge also offers a handpicked team of international specialists who will discuss your case during a virtual conference (at £10,000 that doesn’t come cheap).
Of course, health concierges are not something most of us will ever need. A lot of medical problems have a clear treatment path and can be handled brilliantly by the NHS: you see a doctor, get a diagnosis, get referred to a specialist who offers the gold-standard treatment for that condition, and assuming all goes well, you’re cured.
But many of us no longer solely use the NHS to tackle health problems. We’re using private medical insurance or, increasingly, ‘self-pay’, where you fund a private treatment directly to be seen faster or to get a treatment unavailable on the NHS.
(According to the Private Healthcare UK Self-Pay Survey, self-payment has increased by 25 per cent in London, and 20 per cent around the rest of the country in the past two years.)
‘The primary reason people use us is to help them plot a course through what it a very disjointed and complex private health system,’ says Darren Rowe, CEO of Harley Street Cancer Concierge, which is now expanding into cardiology and mental health.
Its services can extend to transporting you between appointments, auditing bills and, for out-of-town patients, arranging accommodation and even theatre tickets for those well enough to enjoy a relaxing night out. ‘Any illness is incredibly stressful – we help reduce people’s anxiety,’ says Rowe.
Concierges also offer access to treatments perhaps not normally suggested on the NHS. This is what happened with one patient of Dr Sabine Donnai, chief executive at Viavi. ‘She was a young woman with a genetic muscle disease that was affecting her ability to walk,’ she recalls.
‘There’s no established treatment and the prognosis was that she would lose the use of her legs within five years. We investigated the options and found a trial for a new drug being conducted in Newcastle that we have managed to get her on to. No one knows what the outcome will be, but at least we have given her some hope.’
Concierge services also claim to offer a more holistic overview of your illness. ‘Medicine is becoming highly subspecialised – an orthopaedic surgeon might only deal with the hands. That’s great, unless the problem in your hand is actually associated with your elbow,’ says Dr Donnai.
‘What a concierge service does is look at the whole “you” again, which often throws up different solutions.’ Again, for a straightforward diagnosis this isn’t an approach you necessarily need, but for more complex issues it could be vital.
But some doctors are concerned.
‘My first question would be to firmly establish how these companies choose the specialists they refer you to,’ says Dr Mahnaz Hashmi, a consultant psychiatrist working in both the NHS and private sector, and a founder of medstars.co.uk, whose aim is to bring more transparency to private medicine. ‘Ensure that it’s because they really think they are the best people – not because any money is changing hands.’
Sarah is happy with the service she received. ‘I think the main difference, compared to going it alone, is that I don’t feel anything’s being missed, and I’ve got a team around me that cares.
‘Ten days ago I got more bad news: my cancer has spread to my spine. As soon as we found out, the service kicked in and I’m already receiving a tailored treatment. That helps me think that I’m moving in the right direction – which matters when you can’t afford to make any wrong turns.’
Helen Foster 


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