1 Universities & Colleges Personal Healthcare Scheme Working with to offer employees of niversities Colleges access to private healthcare cover
2 Private medical insurance for you and your family The University & Colleges Personal Healthcare Scheme offers university and college employees access to private medical insurance to help ensure you and your family have access to the eligible treatment you need when you need it. The scheme is managed by JLT Benefit Solutions Limited, part of the Jardine Lloyd Thompson Group, and is underwritten by us, at AXA PPP healthcare. We are one of the UK s most experienced private medical insurance providers and have been providing access to private healthcare cover for over 70 years. We currently have over two million members that put their trust in us when it comes to their healthcare cover. Call our Personal Advisers on quoting reference Lines are open 8am-8pm weekdays and 9am-1pm Saturdays. Calls may be recorded and/or monitored for training, quality assurance and evidential purposes.
3 What are the benefits of private medical insurance? Nothing is quite as important as looking after our health, and knowing that we can get the care we need, when we need it. Private medical insurance provides you with prompt access to eligible medical treatment when you need it. It gives you choices too. You can usually decide where you want to be treated, from a national network of over 250 quality-assessed hospitals, including day-patient units and scanning centres. More importantly, you can choose a time that is convenient for you. All you need to do is decide what level of cover you want and choose from the products in our range to suit your needs and your budget. With private medical insurance from AXA PPP healthcare you can rest assured that you ll receive: Joining is simple Available exclusively to university and college employees, this scheme offers you healthcare cover that is simple to join: No medical examination is required. Open to all employees, their partners and dependants (up to 25 years old if in full time education). Automatic acceptance onto the scheme if you join within six weeks of joining your current employer. A range of underwriting methods are available (see page 6 for more information). Prompt access to eligible diagnostic tests to find out what the problem is. The eligible treatment you need when you need it. Comfortable facilities, usually in private rooms with en-suite and TV. Access to Health at Hand, our 24 hour confidential health information line. Cover for cancer treatment. Dedicated Nurse telephone helpline for members who have been diagnosed with cancer Parent accommodation if your child is under 14 and covered under the policy Cash benefit if you stay overnight in a NHS hospital receiving free eligible treatment. The scheme is open to all employees, their partners and dependents (up to 25 years if in full time education). The Universities & Colleges Personal Healthcare Scheme is explained in detail in this brochure. If you have any questions, please feel free to contact our team of expert advisers on: Lines are open 8am-8pm weekdays and 9am-1pm Saturdays. Calls may be recorded and/or monitored for training, quality assurance and evidential purposes. 2
4 Our range of plans We provide a range of plans to suit your needs: Assure Key Ideal Premier In-patient and day-patient treatment explained In-patient treatment is treatment for a patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons. We normally settle all eligible bills for this type of care directly with the hospital or specialist, so you will not be out of pocket. As an in-patient, you are covered for all your essentials during your hospital stay: accommodation, meals, nursing care, drugs and dressings. You will usually have your own private room, with an en-suite bathroom, television and telephone. We will also pay your specialists fees in full, up to the level published in our schedule of procedures and fees. Day-patient treatment is treatment for a patient who is admitted to a hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight. Out-patient treatment explained All our plans include cover for out-patient surgical procedures, radiotherapy, chemotherapy, magnetic resonance imaging (MRI), computerised tomography (CT) and positron emission tomography (PET) scans. All of our plans excluding Assure also cover specialist referred out-patient consultations, diagnostic tests and treatment by a clinical practitioner, including physiotherapy. Complementary therapies acupuncture, homeopathy, osteopathy and chiropractic treatments by recognised complementary practitioners are also covered on all of our plans excluding Assure when you are referred by your GP or specialist (subject to the annual limits on each plan). Help when you re abroad Immediate emergency in-patient treatment abroad The plan you choose with the Universities & Colleges Personal Healthcare Scheme will provide you with limited medical cover when you re travelling abroad. You ll have up to 40,000 of cover for emergency in-patient hospital treatment in an overseas hospital. Please note, this cover is only available when it immediately precedes or follows an emergency evacuation or repatriation we have arranged for you and providing you haven t travelled abroad against medical advice, or gone abroad specifically for treatment. Under normal circumstances there is no cover on the policy for medical treatment received outside the United Kingdom and therefore this cover should not be relied on in place of adequate travel insurance which we strongly recommend you take out whenever you travel abroad. Visit for details of such an arrangement. Evacuation or repatriation service If you can t get suitable or adequate emergency in-patient treatment, we ll arrange for you to be transported to the nearest suitable medical facility or even bring you home for treatment, if necessary. If a member is under 18, or where it is appropriate for the condition involved, we will arrange and pay for someone to accompany them. 3
5 A summary of the cover available Benefits Assure Key Ideal Premier In-patient and day-patient treatment Hospital charges for treatment in a hospital listed in the Directory of Hospitals. Hospital charges for treatment in a hospital not listed in the Directory of Hospitals. Consultant/specialist fees. Diagnostic tests. Radiotherapy/chemotherapy. Psychiatric treatment. Out-patient treatment Surgical procedures. Radiotherapy/chemotherapy. Computerised tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). The 4 benefits detailed below have a combined limit of 400 per year The 4 benefits detailed below have a combined limit of 900 per year The 4 benefits detailed below have no annual limit Consultations with a consultant/specialist. Diagnostic tests. Physiotherapy and complementary practitioners charges. Within the above limit up to a combined maximum of 10 GP referred sessions per year. Within the above limit up to a combined maximum of 10 GP referred sessions per year. Within the above limit up to a combined maximum of 10 GP referred sessions per year. Psychiatric treatment. Additional benefits NHS cash benefit of 50 per night up to 2,000 a year. Day-patient and out-patient NHS radiotherapy and chemotherapy cash benefit of 50 a day up to 2,000 a year. Parent accommodation for one parent to stay with a child under 14 covered by the policy. Private ambulance. Hospital-at-home the cost of a nurse to administer intravenous chemotherapy for the treatment of cancer or intravenous antibiotics at home. When you join, all claims will be assessed against the terms and conditions of your chosen plan, and any exclusions placed on your policy when joining. Private medical insurance is designed to cover the costs of medical treatment of what are known as acute conditions (a disease, illness or injury that is likely to respond to treatment in the near future). Please see page 11 for more information. 4
6 What are the main exclusions and limitations? As with industry standards, general exclusions apply. The following is a summary of the main exclusions and limitations of the policy. Treatment of medical conditions that existed, or you had symptoms of, before joining (unless joining on medical history disregarded underwriting terms). Ongoing, recurrent or long-term treatment of long-term illnesses (usually referred to as chronic conditions). General dental procedures. Routine pregnancy and childbirth. If you choose either the Assure or Key plans; psychiatric treatment. Treatment of injuries sustained from engaging in or training for any sport for which you receive a salary or monetary reimbursement, including grants or sponsorship (unless you receive travel costs only). In-patient or day-patient treatment or MRI, CT or PET scans, oral surgical procedures or cataract surgical procedures not received in a hospital or scanning centre listed in the Directory of Hospitals. We will pay eligible fees in full when a specialist, complementary practitioner or clinical practitioner charges up to the level within our published schedule of procedures and fees. Emergency and urgent treatment Please remember, this is only a summary and full details of cover including terms and conditions will be contained in your membership handbook when you join, or can be obtained from us. Other important information How long will my cover last? Your policy will be arranged for 12 months from the effective date on your membership statement. What do I do if I want to make a claim? If you need to make a claim simply call our team of Personal Advisers on Full details of how to make a claim are included in the membership handbook which you will receive when you join. What do I do if I want to make a complaint? We aim to provide you with the highest possible standards of service but accept there may be occasions when you feel that things have gone wrong for you and you are unhappy with us. If you have a complaint about any matter please contact us and we will do our best to address your concerns. Your feedback is vital to helping us improve. Further details on how to complain can be found in the Complaint and regulatory information section of your membership handbook which you will receive when you join. If you are dissatisfied with the outcome of our investigation, you can ask the Financial Ombudsman Service to consider your complaint. If you have a claim against AXA PPP healthcare In the unlikely event that AXA PPP healthcare becomes insolvent and is unable to pay the benefits under your policy, you are protected by the Financial Services Compensation Scheme (the FSCS). Further information about the operation of the scheme is available on the FSCS website: What if I change my mind? You have a 14 day cancellation period. During this period you have the right to cancel your policy and have your premium returned in line with the terms for cancellation at renewal, as detailed in the Complaint and regulatory information section of your membership handbook which you will receive when you join. The cancellation period begins on the day your contract is agreed or the day you received your full policy terms and conditions if this is later and will also apply from each renewal date. 5
7 What am I covered for? You can join us on any of the policies available to you on the Universities & Colleges Personal Healthcare Scheme on a moratorium or a fully underwritten basis. If you choose either the Premier or Key plan, you may join on a medical history disregarded (MHD) basis. Details of these different underwriting terms are provided below. Moratorium underwriting A moratorium is a set period of time during which you will not be covered for treatment for any medical conditions that you had suffered from before you took out the policy. There s no need to have a medical examination or provide information about your medical history when you join. Medical conditions you ve had in the last five years, and in some cases certain related conditions, will be excluded from cover for the first two years. However, as long as you are completely free of any form of treatment or advice for that condition for a consecutive two year period once you join, we will look at covering it for you in the future. You will be provided with more information about this when you join. Example Back operation in April 2008 Joined AXA PPP healthcare in March 2009 No cover for back condition for a two year period Now covered from March 2011 for this pre-existing condition as two continuous years have passed trouble free of the condition If you have been diagnosed with diabetes, are currently undergoing treatment for raised blood pressure or are currently under investigation, having treatment or undergoing monitoring as a result of a prostate specific antigen (PSA) test, we will exclude the following: If you: Have been diagnosed with diabetes Are currently undergoing treatment for raised blood pressure (hypertension) Are under investigation, having treatment or undergoing monitoring as a result of a prostate specific antigen (PSA) test. You will not be covered for treatment of: diabetes ischaemic heart disease cataract diabetic retinopathy diabetic renal disease arterial disease stroke hypertension ischaemic heart disease stroke hypertensive renal failure any disorder of the prostate Please note If you are over 74 years of age, Moratorium underwriting is not available to you and you will be required to declare your full medical history. For further information, please refer to the range of underwriting options explained in the ABI guide enclosed in your pack. Fully underwritten We ask for you to declare your medical history on your application form. This means that we will tell you which conditions will be excluded from your cover. Medical history disregarded If you choose either the Premier or Key plans, you may be able to join on a medical history disregarded basis, provided your application is received within six weeks of joining your current employer, and providing you can confirm that neither yourself or anyone else covered on the policy, has any on-going claims or treatment planned or pending within three months of the start date of the policy. 6
8 How can I reduce my premiums? The 6 Week Option If you are comfortable using the NHS but worry about potentially long waiting times, then the 6 week option could be for you. If treatment is available on the NHS within six weeks from the date it should take place, then you will use the NHS. However, if the wait for treatment is more than six weeks from when it should take place, then you can go private straight away. Excess options Assure, Key, Ideal and Premier come with a 100 excess as standard. This means you will pay the first 100 of eligible claims once per policy year for each person covered. To reduce your premium even further, you can add an excess of 200 or
9 Care and convenience hand in hand Health at Hand information helpline Health at Hand is a 24-hour telephone health information service for our members. It provides you with immediate access to a qualified team of healthcare professionals when you need it most. The team includes trained nurses, pharmacists, counsellors and midwives. They can give you information on specific illnesses, treatments and medications and provide details of local and national organisations that can help you. They can also arrange to send you free fact sheets and leaflets on a wide range of medical issues, conditions and treatments, and will happily phone you back to discuss any further questions you may have. You can also Health at Hand via our website with one-to-one support whenever you need information about your condition, treatment options available to you or if you simply need emotional support. Your family can also benefit from the helpline if they have concerns or need guidance about your care. Our team of Personal Advisers The AXA PPP healthcare personal touch begins from the moment you join. Our Personal Advisers are on hand to help you:- To discuss the benefits and limitations of your policy. To change your personal details. To give you guidance when arranging treatment. To help you fill out a claim form. To confirm a claims payment. Dedicated Nurse telephone helpline for cancer patients Dealing with cancer treatment can be difficult and so our aim is to provide you with as much support as possible. If you are diagnosed with cancer, we will offer you immediate access to our Dedicated Nurse telephone helpline. A trained nurse will provide you be healthy If you re looking for one central place for health information to help keep your body in tip top condition you need look no further than be healthy. This valuable online resource offers a wealth of useful health tips, articles and tools including fitness programs that you can build to your personal requirements; with videos to help you fully understand the exercises and routines. We have a delicious recipe index for you to browse and there s a section to help keep your mind healthy too with games and memory tips. 8
10 Why choose AXA PPP healthcare? More benefits of being an AXA PPP healthcare member From health and fitness to books and magazines, you can make great savings with our member offers.* These include:- 10% discount off health and wellbeing assessments Substantial eyecare discounts for you and your family 10% off Denby products 10% off fair-trade and organic hampers 18% discount on bikes and accessories Amazing value breaks around England and many more... You ll also receive our free be magazine The magazine is packed with health features, case studies from AXA PPP healthcare members, and a whole range of member offers and competitions. *Correct at the time of going to print. 9
11 Choose from over 250 quality assessed hospitals We have a national network of over 250 hospitals, selected for their quality, value and range of services. You can be assured of receiving prompt treatment in comfortable facilities usually in a private room with television, telephone and en-suite bathroom. 10
12 Chronic conditions In common with other annual insurance policies, medical insurance is designed to cover eligible claims for expenses incurred as a result of unexpected events. Therefore, it is important to understand when buying medical insurance that policies are designed to cover treatment of medical conditions that respond quickly to treatment, referred to by us as acute conditions. Medical insurance is not intended to cover you against the cost of recurrent, continuing or long-term treatment of chronic medical conditions since these treatments become a series of predictable, rather than unexpected, events. This section is designed to help you understand more about what we mean by a chronic condition and provide practical examples of when we will or will not cover treatment of those conditions. What is a chronic condition? A chronic condition is a disease, illness or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and/or tests it needs ongoing or long-term control or relief of symptoms it requires your rehabilitation or for you to be specially trained to cope with it it continues indefinitely it has no known cure it comes back or is likely to come back. At AXA PPP healthcare we cover the cost of treatment for acute conditions. That is, treatment which aims to return you to the state of health you were in before suffering the condition, or which leads to your full recovery. This includes short-term medical intervention to treat unexpected complications or exacerbations of a chronic condition. If your illness or medical condition requires recurring consultations over a long period, checks on your medication, long term therapy or treatment to ease symptoms, your condition may fall within the definition of a chronic condition. If you have been receiving ongoing or continuing treatment or treatment that is intended to manage your condition or keep your symptoms in check, we will review your treatment to assess whether it remains eligible for benefit. What does this mean in practice? For pre-authorised claims, we will tell you if we think your condition is now a chronic condition under our rules. We may then (with your permission) contact your specialist or GP who knows your particular circumstances. We may ask them for confirmation of the diagnosis of your condition and details of the treatment you are currently receiving and to give us a future prognosis for the condition. In line with other medical insurance policies, our plans are designed to cover claims for expenses incurred as a result of unexpected events and we stop paying for recurring or continuing treatment of medical conditions that will continue indefinitely or that keep recurring. Should the information we have indicate that you have a chronic condition we will write to tell you we will stop paying benefit for the continuing or recurrent treatment of the chronic condition. What if your condition gets worse? We will pay for the treatment of acute exacerbations or complications (flare-ups) in order to bring the condition quickly back to its controlled state (for instance in-patient treatment needed to re-stabilise a chronic condition such as diabetes). There are certain other chronic conditions such as Crohn s disease which because of their nature, require management of recurrent episodes during which the symptoms of the condition worsen. Because of the ongoing or continuing nature of such conditions, we will write to tell you when there is no further benefit available for the treatment of that medical condition. Examples of chronic conditions The following are examples of chronic conditions and how we usually deal with them. In all of the following examples we may need to write to you or your doctor to obtain further information, as explained above. Important note certain plans have specific restrictions to benefits such as out-patient treatment, for treatment that could have been received on the NHS within six weeks and other specific exclusions covered in the customer s policy terms. The cover for cancer also varies by product with some products having higher levels of cover than those described in this document while others have lower or no cover for cancer. The examples overleaf are designed to show our general policy on chronic conditions and how we would deal with them for a customer on a comprehensive policy. Please read your handbook carefully to establish what cover you have as all the other terms of your policy (including any limits) will continue to apply to your cover. 11
13 Example 1 Angina and heart disease Alan has been with AXA PPP healthcare for many years. He develops chest pain and is referred by his GP to a specialist. He has a number of investigations and is diagnosed as suffering from angina. Alan is placed on medication to control his symptoms. We would pay for the initial consultation and tests to diagnose the condition and further consultations with the specialist to allow the medication to bring the condition under control. At this point we would advise Alan that further regular review consultations to monitor the condition would not be covered, but we would allow one further consultation to allow Alan to discuss alternative arrangements should he wish to do so. Two years later, Alan s chest pain recurs more severely and his specialist recommends that he has a heart by-pass operation. We would confirm to Alan that we will cover that operation as it will stabilise his condition and substantially relieve his acute symptoms. We would then explain to Alan that although his policy would not normally cover regular check-ups, in this particular circumstance we would allow for a further ten years of annual postoperative check-ups with the specialist to ensure that his condition remains stabilised. This benefit would only be available on policies with out-patient cover and while the policy remains in force. Example 2 Asthma Eve has been with AXA PPP healthcare for five years when she develops breathing difficulties. Her GP refers her to a specialist who arranges for a number of tests. These reveal that Eve has asthma. Her specialist puts her on medication and recommends a follow-up consultation in three months, to see if her condition has improved. At that consultation Eve states that her breathing has been much better, so the specialist suggests she have check-ups every four months. We would agree to cover Eve s initial tests and consultation to establish the diagnosis and also the subsequent consultation to see if there was an improvement. However, we would then advise Eve that regular check-ups are outside the scope of her cover. Eighteen months later, Eve has a bad asthma attack. We would agree to cover the cost of hospital treatment until her condition has been stabilised. We would also pay for one further consultation following discharge from hospital. Example 3 Diabetes Deidre has been with AXA PPP healthcare for two years when she develops symptoms that indicate that she may have diabetes. Her GP refers her to an endocrinology specialist who organises a series of investigations to confirm the diagnosis and she then starts on oral medication to control the diabetes. After several months of regular consultations and some adjustments to the medication regime the condition is now well controlled and the specialist explains he would like to see her every four months to review the condition. We would explain that we cannot continue to provide benefit for the review consultations but, would agree to provide benefit for one more to allow Deidre the opportunity to discuss alternative arrangements for follow up. One year later Deidre s diabetes becomes unstable and her GP arranges for her to go into hospital for in-patient treatment. We would provide benefit for this admission and for a short period after her discharge. Example 4 Hip pain Bob has been with AXA PPP healthcare for three years when he develops hip pain. His GP refers him to an osteopath who treats him every other day for two weeks and then recommends that he return once a month for additional treatment to prevent a recurrence of his original symptoms. We would explain that the monthly visits are not covered by Bob s policy but that, if he should have further problems or if his condition should worsen to the point where a hip replacement is needed, this would be covered if his GP refers him to a suitable specialist. If you would like to discuss any of this with us, please call us on the number below. 12
14 Frequently asked questions Frequently asked questions The following are questions that are frequently asked about our healthcare plans. If you would like any more information please call us on There are lots of medical insurers in the market; why should I choose AXA PPP healthcare? We are one of the largest UK medical insurers with 70 years experience. We want our members to feel confident and secure when they take out our healthcare policies, so customer satisfaction is at the core of everything we do. We are proud to have been awarded Best Private Medical Insurance Provider by Your Money readers in How often can I claim? There is no limit to the number of times you can claim for new conditions that arise after you join, as long as it is within your policy limits, and you can start claiming from when you join. Are my dental costs covered under the plan? Generally no, as this treatment is not a medical condition. However, a small number of oral procedures are covered, so please ask our Personal Advisers for more information. What happens if I have to spend a night in an NHS hospital? For each night you spend in an NHS hospital receiving free treatment that would have been eligible under your policy, you will receive a cash benefit of 50, up to a maximum of 2,000 per year. Do I have to pay for treatment and then claim the money back? No, as we normally receive invoices directly from the specialists or hospitals and will settle them directly within policy limits. How can I be sure that I m covered before I go ahead with treatment? That s simple. Just ring our team of Personal Advisers with the details of your proposed treatment and specialist. They will confirm if your treatment is eligible, so you may go ahead with the peace of mind that you are fully covered. What happens if I have hospital treatment without checking with a Personal Adviser first that it is covered? We would strongly recommend that you obtain authorisation for your proposed treatment before it is undertaken so you can be sure that it is covered. However, if you don t pre-authorise treatment with us we will pay for the claim provided it is eligible under the terms of your policy. What is the 6 week rule and why should I add it to my policy? It s a good way to reduce your premium. If you are comfortable using the NHS but worry about the long waiting times, then the 6 week option could be for you. If the eligible treatment you need is available on the NHS within six weeks of the date the treatment should take place, then you will be treated under the NHS. However, if the wait for treatment is more than six weeks then you can go private straight away. Can you help if I need medical information? When you join, you will have access to Health at Hand, our 24 hour telephone based medical information service. We have a wide range of medical professionals on hand to give you information about medicines, pain relief, pregnancy, cancer, stress, menopause, and much more. 13
15 We want to make it easy to understand your policy Glossary: Medicine seems to have a language all of its own. Here are some terms that we use in this brochure and in your policy with which you may not be familiar. Clinical practitioner A dietician, nurse, orthoptist, physiotherapist, psychologist, psychotherapist or speech therapist who we recognise for benefit purposes. CT scans Computerised tomography scans. A form of X-ray examination. It is particularly useful for making diagnoses in the head, chest and abdomen. Complementary practitioner A practitioner in acupuncture, homeopathy, osteopathy and chiropractic treatment who we recognise for benefit purposes. Day-patient A patient who is admitted to a hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight. Diagnostic tests Investigations, such as x-rays or blood tests, to find or to help to find the cause of your symptoms. Directory of Hospitals A document we publish which lists private hospitals, day-patient units and scanning centres in the UK that we cover. Excess Choosing an excess on your policy may help to reduce your premiums. An excess is the amount of money that you have to pay towards the cost of treatment each year and applies to each person covered by the policy in each year. Family member The policyholder s current spouse or civil partner or any person (whether or not the same sex) living permanently in a similar relationship with the policyholder and any of their or the policyholder s unmarried children. In-patient A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons. Medical condition Any disease, illness or injury, including psychiatric illness. Medical underwriting The process by which we assess your application and decide on what terms we may offer to cover you. Member You and any family member covered by your policy. MRI scans Magnetic resonance imaging scans. A way of medically mapping the body's tissues. It helps with non-invasive diagnosis and treatment planning of a wide range of diseases, including cancer. It doesn't use potentially harmful ionising radiation such as X-rays. Out-patient A patient who attends a hospital, consulting room, or out-patient clinic and is not admitted as a day-patient or an in-patient. PET scan Positron emission tomography scan. A way of diagnosing and monitoring many serious medical conditions, including heart problems and cancer. A very small radioactive injection is given to the patient and a PET camera is used to measure radioactivity in various parts of the body. Physiotherapy Physical treatment such as massage or exercises. Pre-existing conditions A medical condition, and conditions relating to it, which existed before your cover with us started. Radiotherapy and chemotherapy Treatments for cancer. Specialist A senior and experienced medical practitioner who has attained the status of an NHS consultant or equivalent. Surgical procedure An operation or other invasive procedure. Treatment Surgical or medical services (including diagnostic tests) that are needed to diagnose, relieve or cure a disease, illness or injury. 14
16 JLT Benefit Solutions Limited. Authorised and regulated by the Financial Services Authority. A member of the Jardine Lloyd Thompson Group. Registered Office: 6 Crutched Friars, London EC3N 2PH. Registered in England No VAT No For more information on our private medical insurance, call us at AXA PPP healthcare on: quoting reference ISO14001 PB40248/04.11 AXA PPP healthcare, Phillips House, Crescent Road, Tunbridge Wells, Kent TN1 2PL. AXA PPP healthcare limited. Registered Office: 5 Old Broad Street, London EC2N 1AD, United Kingdom. Registered in England No Authorised and regulated by the Financial Services Authority. AXA PPP healthcare Calls may be monitored and/or recorded for training, quality assurance and evidential purposes..