The Royal College of Surgeons (RCS) has spoken out strongly about Bupas medical review process for knee arthroscopy. In reference to the insurers move to introduce a pre-authorisation process for knee arthroscopy, the RCS said in a protracted statement: The College does not support any third party review of a consultants decision to treat a patient. There are very clear clinical guidelines laid down by NICE and by individual specialty associations and there is no need for a decision to be reviewed by another consultant or anyone else, unless it is at the request of the patient or the consultant.