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GPs buried under trusts' workload dump

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)

  • If anyone is given as much rope as Babylon have been handed, there will only be one outcome.

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  • Babylon just invented ‘capitated patient sickness arbitrage using tech’ as a way to make money.

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  • All what these guys will be doing is giving out antibiotics for sore throats. It’ll be a disgrace if they get away with their exclusion criteria. What they’re offering is NOT general practice! What’s the college doing to address this? Will practices in London left with the extra work get Etta pay?

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  • Scarcely credible, even with the current DOH politics.
    Highly dubious that it would meet contract requirements. Also medicolegally dangerous. Urgent CQC inspection required?
    As regards the exclusions, perhaps other practices in the relevant areas of London should adopt the same list of conditions which could exclude new patients from registering, advise their local health authority and see what happens!

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  • Vinci Ho

    You see
    I have been too busy dealing with these patients on this list of exclusion today and only now I can sit down to have my tea as well as reading this properly.
    As I always wrote , sign of the times . This phenomenon is totally unsurprising to me .
    Supported by Charles Alessi , typically this is the role model we all should be looking upon accordingly . We all have to develop a smartphone appt and provide video consultations , as in line with Agent Hunt’s obsession of smartphone technology. We all should develop Facebook accounts for our surgeries. (Mark Zuckerberg will be so f***ing delighted!)
    Obviously, informations provided in this article are limited. If the service is legitimately recognised by NHS . One will be more than intrigued to know exactly what are terms and conditions laid down for Babylon from the government.
    Yes , this is perhaps one ‘logical’ Londonian solution to satisfy those patients who spent mega hours on smartphones everyday .But again , like all stories repeated under the government: one size will fit all!
    For the sake of discerning the facts of this matter before applying our ethos of true general practice to respond, Nigel, please provide more details and facts on this ‘deal’ between Babylon and the government.

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  • Vinci Ho

    PS
    Is the beginning of our end ,as Luke Skywalker said in the forthcoming Last Jedi trailer , “I only know one truth: It’s time for the Jedi to end.” ??

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  • I can feel an FOI request coming on, maybe 'could NHSE/CCG supply a copy of the equality impact assessment which was hopefully undertaken as part of the procurement process?'

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  • Vinci Ho

    *Private hospitals provide surgical procedures for NHS with their strict set of exclusion criteria.
    *APMS private provider can operate under different terms and conditions , and leaves the table anytime they like(yes, one can argue we can do the same as well).
    *Now you have these new smartphone GP variant, but with a strict exclusion criteria of patient types , presumably being paid ,at least ,the same rate as other practices which will be left with a concentration of more patients with complex problems but with no extra resources from government.

    One thing so far we have learnt from the cause(s) of this current world messy situation is :
    Neo-liberalism with globalisation ,advocated by elites ,had encouraged liberty . But liberty had taken equality for granted and exaggerated instead of resolving inequality in various aspects..........

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  • Saw it advertised on the tube. 24/7 access to GP any time any where and for free. Massively undervalues GP care. How much do the GP slaves earn??

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  • Vinci Ho

    For those who are missing Dr Alessi, revisit this on this platform exactly three years ago:


    http://www.pulsetoday.co.uk/clinical/more-clinical-areas/neurology/gps-to-diagnose-and-care-for-dementia-like-other-long-term-conditions-says-government-advisor/20008568.article

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