Background
Summary of Council decision:
Three issues were investigated, all of which were Upheld.
Ad description
Advertising for a private clinic seen in August 2016:
a. The website www.candoverclinic.com featured a header on the “Our Facilities” page that stated “Candover Clinic Private Healthcare*”. Below that was further text that stated “Purpose built in 2013 the Candover Clinic and Suite is a dedicated private patients unit funded and operated by Hampshire Hospitals NHS Foundation Trust Fund”. Below this was another header that stated “About Candover Clinic” with the text “Candover Clinic offers comprehensive healthcare options within four impressive units: … Diagnostic Imaging … For maximum patient convenience, under the same roof as the clinic, our diagnostic imaging unit include MRI … Our state-of-the-art MRI magnet has the widest bore and shortest length magnet in the area, providing the most comfortable patient experience as well as superior diagnostic images … How Candover is different … Being located on the site of a well-respected district hospital offers patients a very high level of safety and reassurance, including access to critical and specialists units not available in nearby private hospital sites …”.
b. The bus ad featured text that stated “Candover Clinic is the new superior private healthcare option in the Basingstoke area”.
Issue
BMI Healthcare Ltd challenged whether the following claims were misleading and could be substantiated:
1. “Our state-of-the-art MRI magnet” in ad (a);
2. “… access to critical and specialists units not available in nearby private hospital sites” in ad (a); and
3. “Candover Clinic is the new superior private healthcare option in the Basingstoke area” in ad (b).
Response
1. Candover Clinic stated that they had installed the 1.5 Tesla MRI system, which was the latest model commercially available and that the hardware specifically had not been superseded. The software was regularly updated by the manufacturer which Candover Clinic continuously installed onto their MRI machine.
2. Candover Clinic stated that they were the private patients unit of Hampshire Hospitals NHS Foundation Trust (HHFT) and were based on-site at Basingstoke and North Hampshire Hospital (BNHH). They cared for patients using both dedicated private facilities and those of BNHH when needed.
Candover Clinic stated that although BMI Healthcare’s Hampshire Clinic offered some critical care services, they did not have the appropriate and specialist intensive treatment unit which Candover Clinic had direct access to at BNHH, and to where the most poorly patients were regularly transferred. They stated that unlike the Hampshire Clinic, the Candover clinic was fully embedded within BNHH and therefore, a patient could be transferred to BNHH for intensive care or any specialist service without the need for vehicle transportation. Candover Clinic further stated that unlike BMI Healthcare’s Hampshire Clinic, they had direct on-site access to a specialist cardiac catheter laboratory, a fully equipped coronary care unit (CCU), a cardiology ward, a cardiothoracic investigations department and a pacing service.
Candover Clinic also had on-site access to a large pathology department that provided biochemistry, haematology/blood transfusion, cellular pathology and microbiology service “in-house”. Candover Clinic stated that these facilities were not available at the Hampshire Clinic, which had contracted with the HHFT to provide its pathology service.
3. Candover Clinic stated that the claim “Candover Clinic is the new superior private healthcare option in the Basingstoke area” was based on a comparison with the facilities, services and range of treatments available at BMI Healthcare’s Hampshire Clinic. They explained that Candover Clinic offered a range of treatments and services that were not available at BMI Healthcare’s Hampshire Clinic, which included cardiology and interventional radiology.
Candover Clinic stated that private patients admitted to BMI Healthcare’s Hampshire Clinic were regularly transferred by “blue light” ambulance to BNHH for critical care when they became too ill. The transfer involved approximately a 20-minute delay in the patient receiving critical care, whereas private patients at the Candover Clinic could be transferred to the intensive care unit at BNHH without an ambulance and within minutes.
Candover Clinic stated that some surgeons would not undertake major cases at BMI Healthcare’s Hampshire Clinic, preferring the multi-facetted support and safety of the general hospital environment where the Candover Clinic was located. Furthermore, they stated that they had onsite access to a 24-hour, 7-day a week primary cardiology angioplasty service, which was not available at BMI Healthcare’s Hampshire Clinic. This, they stated, was the gold standard treatment for heart attack patients.
Candover Clinic stated that they had a better building specification and décor because they were a newer establishment with up-to-date features in all patient areas, whereas they considered BMI Healthcare’s Hampshire Clinic was dated. In particular, they looked at patient accommodation – for example, they had hygienic infection-control solid flooring whereas BMI Healthcare’s Hampshire Clinic had carpeted patient rooms.
Regarding patient comfort, Candover Clinic stated that they compared aspects such as the modern wide-bore MRI they offered against the more restricted and older narrow-bore system at BMI Healthcare’s Hampshire Clinic. They stated that their MRI offered patients more space inside the machine, which significantly reduced the induction of claustrophobia.
Candover Clinic provided statistics comparing how satisfied patients were with specific elements of care/experience they had received from their clinic and The Hampshire Clinic, having given a mark of either “excellent” or “very good”. To make the comparison, Candover Clinic used and provided a leaflet published by the Hampshire Clinic, which showed their 2016 “Patient Satisfaction Scores”. They believed that this further illustrated that Candover Clinic was the superior private healthcare option in the Basingstoke area.
Assessment
1. Upheld
The ASA considered that consumers would interpret the claim “Our state-of-the-art MRI magnet” in ad (a) to mean that Candover Clinic owned the most advanced MRI machine available on the market, producing the most detailed images of the internal anatomy of a patient’s body that technology could offer. We understood that magnetic resonance imaging (MRI) was a type of scan that used strong magnetic fields and radio waves to produce detailed images of the inside of a body. Furthermore, the magnet component of a MRI scanner was a material part of the machine’s function in providing a detailed picture of the human body, and that the higher the magnet’s strength (Tesla – unit of strength of a magnetic field) the better the image would be.
We understood that the most powerful MRI scanner on the market used a 7 Tesla magnet and that, in contrast, Candover Clinic used a 1.5 Tesla magnet in their MRI machine. Because the MRI scanner used by Candover clinic was not the most advanced machine available we concluded that the claim “Our state-of-the-art MRI magnet” in ad (a)” was likely to mislead consumers.
On that point ad (a) 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) and 3.11 3.11 Marketing communications must not mislead consumers by exaggerating the capability or performance of a product. (Exaggeration).
2. Upheld
We considered that consumers would interpret the comparative claim “Being located on the site of a well-respected district hospital offers patients a very high level of safety and reassurance, including access to critical and specialists units not available in nearby private hospital sites” in ad (a) to mean that Candover Clinic was the only private clinic in the Basingstoke area which offered patients critical and specialist treatments, whether those treatments were available on that hospital’s site or in a nearby location.
We noted that Candover Clinic acknowledged in their response that they were aware that some critical care services were available at BMI Healthcare’s Hampshire Clinic. Having further liaised with BMI Healthcare we understood that their Hampshire Clinic offered “Level 3 Critical Care” and provided specialist practices including a peritoneal malignancy service and gastro-intestinal surgery.
Candover Clinic had stated that the Hampshire Clinic did not have an appropriate specialist intensive treatment unit, which resulted in transferring the most unwell patients to BNHH. However, we understood that this was also the case for Candover Clinic, which was a private patients unit of HHFT that referred patients to the NHS hospital when needed.
Therefore, because Candover Clinic had not provided sufficient evidence to support the claim “access to critical and specialists units not available in nearby private hospital sites”, we concluded that it had not been substantiated and was misleading.
On that point ad (a) 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), 3.11 3.11 Marketing communications must not mislead consumers by exaggerating the capability or performance of a product. (Exaggeration) and 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. (Comparisons with identifiable competitors).
3. Upheld
We considered that consumers were likely to regard the claim "Candover Clinic is the new superior private healthcare option in the Basingstoke area” in ad (b) to be objective, and because of the strong reference to “superior”, meant that Candover Clinic had been given recognition by an official body that they provided a significantly higher quality of care than any other private healthcare provider in the Basingstoke area. However, Candover Clinic had based the claim on their own views as to why they believed they provided a better quality of care than BMI’s Hampshire Clinic along with statistics showing how satisfied their patients were with their services and comparing them to The Hampshire Clinic’s published “Patient Satisfaction Scores”.
Regarding Candover Clinic’s patient satisfaction scores, we had not received the full set of results of their completed questionnaires. Notwithstanding that, we noted that the patient score for “overall quality of care” marked as “very good” or “excellent” were significantly high for both Candover Clinic and the Hampshire Clinic (99.5% and 98.4% respectively), with a marginal difference of 1.1%. Furthermore, we noted that whilst the statistics showed that Candover Clinic had scored higher than the Hampshire Clinic on each aspect of service that a comparison was drawn against, the Hampshire Clinic nevertheless, continued to score highly (ranging between 82.6% and 99.4%). We also noted that the questionnaire carried out by the Hampshire Clinic had been completed by 591 patients whereas Candover Clinic had a sample size of more than double that value (1,287). We considered that such a significant discrepancy between the two sample sizes was likely to skew the comparative statistics.
Therefore, because we had not seen adequate objective evidence to support the claim “Candover Clinic is the new superior private healthcare option in the Basingstoke area” in ad (b), we concluded that it had not been substantiated and was misleading.
On that point ad (b) 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), 3.11 3.11 Marketing communications must not mislead consumers by exaggerating the capability or performance of a product. (Exaggeration) and 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. (Comparisons with identifiable competitors).
Action
The ad must not appear again in its current form. We told Candover Clinic not to make comparative, superiority and “state-of-the-art” claims unless they could be supported with robust objective evidence.
