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Gold, incentives and meh

Online GP provider makes push for patients to switch from their practices

Babylon Health has started offering their online GP service up as a replacement to regular GP practices across London, with plans to expand the service to the rest of England.

But GP leaders warned that the company was 'cherry picking' patients, 'creating a twin-track approach to NHS general practice'.

The company has launched its service to London patients, via a GMS contract, with plans for 'rolling out across the country in the near future'.

It promises that patients will be able to 'book an appointment within seconds' via its smartphone app and have 'a video consultation with an NHS GP typically in under two hours of booking, anytime, anywhere'.

It says patients will also be able to have 'an in-person appointment if needed at convenient city centre locations on the same or next day' as well as having precriptions delivered to 'a pharmacy of their choice'.

In a letter to patients seen by Pulse, Babylon said: ‘Anyone switching their registered NHS GP practice to GP at hand will continue to get 24/7 access to all the Babylon features with the additional benefit of being able to see an NHS GP in minutes on their phone for free.’

When patients need to see a GP in person, they can choose GP clinics in Canary Wharf, Victoria, Liverpool Street and Euston and get an appointment on the same or next day, Monday to Saturday.

Babylon Health said that it had trialled the service in Fulham with ‘thousands’ of patients and the service had now been launched across London with ‘other cities to follow’.

Babylon said, however, that patients with the following conditions could be excluded from the service:

  • Women who are or may be pregnant
  • Adults with a safeguarding need
  • People living with complex mental health conditions
  • People with complex physical, psychological and social needs
  • People living with dementia
  • Older people with conditions related to frailty
  • People requiring end of life care
  • Parents of children who are on the ‘Child at risk’ protection register
  • People with learning difficulties
  • People with drug dependence

Babylon Health medical director and GP Dr Mobasher Butt said: We can put patients in front of a GP within minutes on their phone, so the days of ringing frantically at 8am for an appointment should be long gone.’

Dr Charles Alessi, a GP and senior advisor at Public Health England said: 'The GP at Hand service is a true NHS primary care service - helping people stay healthy as well as looking after them when they are sick. People want to be in control of their health, and through Babylon's technology GP at Hand makes that possible. '

But RCGP chair Professor Helen Stokes-Lampard warned of unintended consequences of the new service.

She said: ‘Some patients will see this as a "golden ticket" to get quick and easy access to a GP - and for younger, healthier commuters it could prove a solution to long waiting times for an appointment.

'We are really worried that schemes like this are creating a twin-track approach to NHS general practice and that patients are being ‘cherry-picked’, which could actually increase the pressures on traditional GPs based in the community.'

She added that the RCGP was concerned patients were 'being given the option of switching back to their local surgery if they are not satisfied with the level of service offered by the app'.

'As well as issues with patient confidentiality and the safety of the patient record, it is hard to see how this could be achieved without adding to the huge burden of red tape that GPs are already grappling with,' she said.

'While this scheme is backed by the NHS and offers a free service to patients, it is undoubtedly luring GPs away from frontline general practice at a time when we are facing a severe workforce crisis and hardworking GPs are struggling to cope with immense workloads,' she added.

BMA GP Committee chair Dr Richard Vautrey said: 'While these proposals appear to be focused on making access to a GP easier, in reality it will divert patients away from their GP and practice and leaves them receiving care from doctors who don't know them as well as their own GP would do.

'This approach risks undermining the quality and continuity of care and further fragmenting the service provided to the public. It is also delivered by a private company that is primarily cherry picking younger, generally healthier people and excluding many others.

'It will do nothing to help the growing number of older, vulnerable patients who need well funded services that can provide the specialist care they need in the community.'

But Babylon Health said pilots had seen 'a broad range of patients benefiting from being able to see a GP quickly and at the patient's convenience, including elderly patients who find it difficult to get to surgeries because of mobility problems'.

A spokesperson told Pulse: 'The RCGP are completely incorrect to say certain groups of people are not eligible or excluded for this service.

'As in line with NHS guidance, for patients with certain conditions, as with any other care provider, our doctors will assess patients needs and in some circumstances may recommend other care is more appropriate and guide patients through getting that care, at all times putting the needs of the patient first.'

Babylon has previously aimed to replace call handlers in the NHS 111 service with a pilot of its triage app using machine learning to hone the accuracy of the recommendations it gives to patients.

Readers' comments (63)

  • yes but there is a gap in the market and an opportunity to make some quick money.

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  • National Hopeless Service

    We have decided to become a sunglasses practice. We will all wear sunglasses so we cant do any dermatology, Ophthalmology or anything else with a 'scope and cervical smears. And I cant do feet, I just dont like feet.

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  • How does the service meet contractual requirements, GMC requirements, CQC requirements and not fall foul of anti-discriminatory law? RCGP, BMA, GMC, CQC and patient support groups should be jumping all over this.
    “You may on occasion develop an urgent illness which requires a face to face appointment, and not be able to visit one of our GP clinic locations. In this circumstance, we may ask you to call 111 who will direct you to the most appropriate local service which may be a GP practice near to where you live, the local walk-in or urgent care centre, A&E or minor injuries unit.” So, other practices and A&E will have to see their urgent patients and other practices will be badgered for a home visit by non-registered patients, with no source of remuneration for those contacts.
    If people want to pay money for this service as a top up for NHS care, that’s fine. But this is not an NHS GP service that offers cradle to the grave universal care and should not be allowed to practice in a way that is advantageously different from the 99+% of other GP practices who contract their services to the NHS.

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  • Bob Hodges

    Being a GP is a tough job, but take away the list of people that Babble On are excluding, and you've taken away ALL of the intellectually interesting and vocationally rewarding work from the job.

    I'd seriously question anyone who thinks that that a 'differentiated' patient population can provide sufficient exposure to actual disease to remain registered to practice as a GP.

    Aside from that, it sounds like Babble On have peddled the eEmperor's iClothes to the DoH, and now they're dancing like they got their disco pants on.

    The rest of us who understand that General Practice and continuity actually involves being in the same room as a patient some of the time, will sit by bemused whilst this dies the silent, excruciating death it deserves.

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  • Jeremy Hunt loves this info-capitalism so much his middle name is iMac.

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  • I've just had a look at the Babylon Health website and I honestly don't know how we have ended up in this truly shocking situation.

    What I would really like to know is how are these shysters paid for cherry picking well patients? I'm sure they do not receive the pathetic global sum of £85.35 a year for limitless consultations, day or night. I bet they have a payment by activity model - something which is considered vulgar for us minions.

    And how the hell does this pass equality and diversity laws? Someone with drug addiction or complex health needs is being denied access to an NHS service - how is this even possible? How did we get here?

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  • Dear All,
    ....and Dr Ali Parsa, didn't he do something with Circle in Cambridge?
    Regards
    Paul C

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  • Agree with all the above
    Most of us went into GP to care for ALL patients regardless of complexity.
    First year medical students learn the ethical principles of equality justice benificence non-malificence
    Notwithstanding this sad state of affairs, the current GP shortage , burnout , and threats to leave NHS are the sad results of years of underfunding and governments squandering the remaining vestiges of goodwill.
    Doctors do need to ask themselves however, if working for such an organisation is ethical or a dereliction of what GP is about. You will have a pretty boring job as a salaried lackey pandering to the ‘me now ‘ city types
    While at the same time building profits for businesses cashing in

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  • Dear Shaba , It is happening because Mr Hunt wants it to happen.
    It is such an immoral excluding set-up who else would allow it to take off.

    It will have no impact on health care because anybody who is ill can't join up.

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  • How did they get a GMS contract for this service ?

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