Representing Independent Physiotherapy: A Conversation with Aviva
Physio First recently facilitated a meeting bringing together three senior representatives from Aviva, Tash representing the MSK Partners Network (MSKPN), and Ash James, Professional Adviser at the Chartered Society of Physiotherapy (CSP). The aim was to discuss the future of private healthcare, musculoskeletal services and the role of independent physiotherapy.
The discussion was open, constructive and provided valuable insight into Aviva's strategic direction, while giving the profession an opportunity to raise the issues that matter most to independent physiotherapy providers.
Aviva's direction
Aviva outlined a clear strategic focus on prevention, digital innovation, artificial intelligence and improving patient pathways. They described a future where healthcare is increasingly driven by value, outcomes and supporting people to remain healthier for longer.
Following significant post-COVID growth in the private medical insurance (PMI) market of around 5–6% annually, Aviva reported that growth has now slowed to around 1–2% as affordability pressures increase. Their ambition is to continue growing by improving both the customer experience and the effectiveness of the services they commission, while offering members value beyond healthcare alone.
The profession's perspective
The meeting provided an opportunity to discuss several important issues affecting independent physiotherapy.
These included:
- the challenges created by a single national fee structure despite significant regional differences in operating costs;
- recognising the value of experienced physiotherapists in managing complex cases, reducing unnecessary onward referrals and supporting better long-term outcomes;
- the importance of measuring success through meaningful outcomes rather than simply treatment activity or session numbers; and
- ensuring independent physiotherapy remains central to delivering accessible, high-quality MSK services.
The opportunity
One of the most positive aspects of the discussion was the shared recognition that healthcare is increasingly moving towards demonstrating value through robust outcomes.
This presents a significant opportunity for independent physiotherapy. However, there remains a gap between recognising value conceptually and recognising it commercially. If outcomes are genuinely to drive future healthcare, I hope we will also see that reflected in how physiotherapy services are valued and reimbursed.
Our sector is already building that evidence through initiatives such as Data for Impact (DFI) and the outcomes being collected by clinics involved with the MSK Partners Network. As these datasets continue to grow, they have the potential to demonstrate not only improvements in pain and function, but also the longer-term value of physiotherapy in helping people remain active, reducing repeat episodes and making better use of healthcare resources.
As outcome-based commissioning develops, we believe there is an opportunity for insurers to recognise clinics that actively contribute to collecting high-quality outcomes data. Supporting the generation of robust evidence benefits patients, clinicians and insurers alike and helps ensure future service development is based on measurable value.
What does this mean for members?
Overall, the meeting was encouraging. Aviva was receptive to discussion, interested in the evidence being generated within independent practice and open to continuing dialogue around experienced physiotherapists, advanced practice and future service development.
However, one message particularly stood out.
Aviva's view is that its current fee structure is broadly working because practitioner registrations continue to increase and relatively few clinics have chosen to leave the network. Whether we agree with that conclusion or not, it reflects the evidence they are currently seeing.
It serves as a reminder that perceptions of value are influenced by both the evidence available and the realities of the current market.
Every clinic must make its own commercial decisions, and Physio First cannot advise members on individual pricing or contractual arrangements. However, if fees are genuinely not commercially sustainable but continue to be widely accepted, insurers will understandably conclude that those fees remain commercially viable.
Alongside continuing to build the evidence demonstrating the value of independent physiotherapy, we also need to ensure our business decisions reflect the true cost of delivering high-quality care.
The meeting also reinforced the importance of maintaining constructive dialogue. Change is unlikely to happen through a single conversation, but by continuing to share evidence, demonstrate outcomes and represent the views of independent physiotherapy, we have the opportunity to influence future thinking and service development.
Physio First will continue to work collaboratively with insurers and partner organisations to ensure the voice of independent physiotherapy is heard and supported by robust evidence. The future for physiotherapy remains positive. Demand for MSK services continues to grow, prevention is becoming a greater priority, and high-quality outcomes data will play an increasingly important role in shaping future healthcare. Independent physiotherapy is well placed to lead that future, provided we continue to demonstrate and be recognised for the value we deliver.
How you can help
The more evidence and real-world experience we can bring to these discussions, the stronger the voice of independent physiotherapy becomes.
If you have experiences, positive or negative of working with insurers, examples of innovative practice, or evidence demonstrating the value of your service, we'd love to hear from you.
Your feedback directly informs our conversations with insurers and other stakeholders, helping ensure future discussions are grounded in the realities of independent practice and focused on the issues that matter most to members.