Ad description

A website, www.betterasone.co.uk, for a private healthcare provider, seen in March 2014, included a table which was headlined "Rapid peace of mind with as.one" and which included a list of corresponding statements under the titles "TREATMENT WITHOUT AS.ONE" and "TREATMENT WITH AS.ONE" which listed the procedures to treatment through a GP and through Better as one Ltd. Under the 'without' title, text stated " Week 1: Call your GP surgery to get an appointment Week 2: Meet your GP to discuss your symptoms Week 3: meet your GP again to review your progress Week 4: Meet your GP again - specialist referral if no progress Week 5 Get in front of a specialist. Even now there is a risk you won't see the best specialist for your conditions. Some GP's have limited connections with NHS secondary care. This could mean further referral and delays before you achieve peace of mind and the correct treatment plan. Week 6: possible onward referral to different specialist Week 7: diagnosis and essential tests arranged Week 8: Treatment on the NHS or private treatment arranged if you prefer". Text under the 'without' title stated "week 1: Call our consultant triage team, Get in front of a specialist Week 2: Diagnosis and essential treatment tests arranged Week 3: Fast track to treatment on the NHS or private treatment if you prefer".

Issue

The complainant, a General Practitioner (GP), challenged whether the comparison outlined in the ad misleadingly represented GPs and the service they provided.

Response

Better as.one Ltd said that the ad was intended to show the actual and perceived problems patients had in the current primary (GP) and secondary (specialist) referral system including possible delays in patients being referred to a specialist, the possible referral to an incorrect specialist and possible delays in diagnosis. They said the ad was designed to illustrate that Better as.one was for those patients who wanted to see the correct specialist, regarding their symptoms, for advice and guidance quickly and conveniently. They believed that in doing so, it would reduce the number of unnecessary appointments in GP practices, where patients simply asked to be referred on, and consequently freed up GP appointments.

They believed it was clear from the context of the website as a whole that the presented information was a general overview of the potential scenario that might be faced through referral with a GP and with Better as.one and illustrated the fact that Better as.one could offer a fast track process. They believed the illustrative nature of the table was partly demonstrated by the use of conditional word "could", used in one of the comparative examples and that consumers would not understand the comparisons as absolute fact. They believed that, in any event, the number of instances in which the comparative events occurred was sufficient to support the claims and that the time-table was a fair representation of the two systems.

They provided evidence, including a letter from Better as one to the Royal College of General Practitioners and articles from various online news publications regarding GP services. A BBC article dated June 2014 was supplied which reported that the British Medical Association (BMA) were warning that underfunding was resulting in longer waiting times to see a GP and that "patients were often having to wait one or two weeks for an appointment". They also provided patient stories regarding delays in services, which they believed demonstrated patients' perceptions of GP services and the actual delays in seeing a GP and being referred to a specialist. They also provided a 2012 document published by The Patients Association, the GP Patient Survey for 2012/2013 and details from their website about their own consultants and 'Member Stories' to illustrate their customer's experiences.

Assessment

Upheld

The ASA considered that consumers visiting the website would understand from the content that Better as.one offered a referral system for medical diagnosis from a specialist through to treatment and that the table which included the titles "Treatment with as.one" and "Treatment without as.one" would be understood as a direct comparison of the typical patient referral time from GP visit to specialism (and then on to NHS treatment) compared to the same referral to specialism on to NHS treatment though Better as.one.

We considered the ad presented the comparative time-frames as the normal time frames experienced by the majority of patients using each service (as opposed to 'patient perception' of potential events under both systems) and therefore considered that Better as one would need to provide robust documentary evidence to demonstrate that the services and timeframes detailed in the ad were an illustration of the services typically achieved under both systems.

We considered that the ad implied it was typical for members of the public to have to wait for a week to see their GP and noted a variety of evidence was supplied in support of that claim. We considered that published news articles did not constitute documentary evidence that was capable of substantiating the objective claims in this ad and noted much of the referenced source material in the articles was not supplied. Furthermore, some of the articles, such as the BBC article about the BMA, post-dated the complainant seeing the ad.

Better as.one did supply the NHS Patient Survey (referenced in some of the news articles) which stated that from June 2012 - 2013, 14.25% (average) of the survey respondents (which comprised a 35% response rate) stated that they waited for a week or more for an appointment. The report also stated that 36.25% of patients (over the same period) got an appointment on the same day, 13.5% the next day and 32.75% a few days after their initial request to see a GP. We therefore considered the implied claim that it typically took a week to obtain a GP appointment was not substantiated by the submitted evidence.

We considered the ad implied a second GP visit and a five week wait was typically required before specialist referral could be offered and although a news article (which post dated the complainant seeing the ad) raised concerns about the referral system, we did not consider this to be objective evidence that was capable of substantiating such a claim. Although the submitted Patients Association report raised concerns about referrals to secondary care and the 'rationing' of some treatments, including some surgeries, documentary evidence was not submitted to demonstrate that patients generally waited five weeks to see a specialist following a GP visit or that it took eight weeks to get the appropriate NHS treatment.

Further, the ad stated that through GP services, the most appropriate specialist was commonly not recommended in the first instance, potentially requiring secondary referral adding further time till diagnosis and treatment. Whilst anecdotal evidence in the form of patient stories were supplied alongside the perceptions of patients regarding their experience of specialist referrals (as outlined in The Patients Association publication), we did not consider such anecdotal evidence to be capable of substantiating the comparative claims regarding the amount of time taken to see the most appropriate specialist.

They supplied a 2012 document published by The Patients Association which referenced concerns some NHS patients had with referrals to acute services (secondary care). Whilst the document suggested there were some perceived problems with referrals to specialists, we considered this information did not constitute documentary evidence that specialist diagnosis and treatment via GP services typically took eight weeks. Furthermore, it did not constitute robust evidence that GPs typically referred patients to the wrong specialist in the first instance and that this was due, in part, to GPs "limited connections" with NHS secondary care.

Finally, although anecdotal evidence was supplied explaining examples of services and time frames for those services through Better as.one, documentary evidence was not supplied to demonstrate that the stated time frame from initial contact with Better as one through to referral for NHS treatment following specialist diagnosis was representative of the services offered, or that referral to the NHS (or private care) resulted in 'fast track' treatment on the NHS (in week three).

Because robust documentary evidence was not provided to demonstrate that any elements of the presented services or time frames were typical of GP services compared to that of Better as one, we concluded that the ad was misleading.

The ad breached CAP Code (Edition 12) rules  3.1 3.1 Marketing communications must not materially mislead or be likely to do so.  (Misleading advertising),  3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.  (Substantiation),  3.33 3.33 Marketing communications that include a comparison with an identifiable competitor must not mislead, or be likely to mislead, the consumer about either the advertised product or the competing product.  and  3.35 3.35 They must objectively compare one or more material, relevant, verifiable and representative feature of those products, which may include price.  (Comparisons with identifiable competitors).

Action

The ad should not appear again in its current form. We told Better as.One Ltd to ensure it held robust documentary evidence to support its comparative claims.

CAP Code (Edition 12)

3.1     3.33     3.35     3.7    


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