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GPs buried under trusts' workload dump

Digital practice patients three times more likely to return to prior GP surgery

The proportion of patients deregistering from a digital GP provider and returning to their original practice is three times higher than patients switching between traditional practices.

In London - where digital provider Babylon GP at Hand is based - more than a third of patients at digital practices go back to their previous GP surgery within a year of moving to the new one, according to NHS England analysis. 

But at traditional practices in London just 12% of patients deregister within 12 months to return to their prior GP, said NHS England, which carried out the analysis as part of a new consultation on rules for providing digital-first primary care.

Babylon has said according to its own analysis, its patient churn is now around the London average.

Documents published by NHS England last week concluded that digital-first providers have a higher patient churn - the rate of registration and subsequent de-registration.

They also said it was 'likely' digital-first GP practices would continue to have a high rate of patient registrations as these services expand.

NHS England is therefore proposing new rules that would mean GP practices only receive their patient registration premium - extra money for new people added to their list - if a patient remains registered with a new practice for a minimum of between six and 12 months.

The NHS England documents said: ‘We know that the proportion of patients in London practices returning to their original practice within one year of moving to a new practice is 12%, while for digital models it is more than three times that rate.’

They added: ‘The premium does not fully account for patient churn. This is because it is calculated at the end of each quarter, based on the proportion of a practice’s registered list that joined during the previous twelve months.’

But a Babylon spokesperson said that as GP at Hand has become more established, fewer patients have been deregistering.

The spokersperson said: 'The longer Babylon GP at Hand has been running, the less patients have been leaving and our most recent figures show that patients are leaving Babylon GP at Hand at around the London average rate for practices.

'Our culture has a strong focus on continual improvement, and it’s our ambition to make our service so good that this rate will continue to drop and, as we expand with more clinics across the UK we expect that people will stay with us even if they are moving to a new job or home.'

Readers' comments (7)

  • patients aren't dumb - they use these services for what they need and then re register with own practice, as they expand expect to see patients abandoning defined lists and registering wherever they want when they want for what they want - similar to north america - except you lose continuity of care, its a paradise scenario for drug abusers and causes excessive costs by double doctoring which is extremely common. it may seem cost effective on the surface but it really isn't. most countries with this type of system are already looking to abandon it as it costs too much.

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  • Vinci Ho

    My speculation is if Mr Johnson becomes the next PM which looks more likely up to now , the current health secretary will be rewarded a more promising position in the cabinet ( as nobody really wants to be the health secretary in this country if one has a choice ) for supporting him . This loop hole in the GMS contract allowing GP at Hand to grow will be tightened up .

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  • Not surprised. Patients are not stupid.

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  • Rogue1

    If patients have used a digital service we should be able to decline to re-register them, but instead point them to the local walk-in centre. If the government want to promote digital then they should back it up, patients simply wandering back-in at will needs to be discouraged

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  • The consultation - well worth reading & considering the implications for general practice and your local health communities
    https://www.england.nhs.uk/wp-content/uploads/2019/06/digital-first-primary-care-consultation.pdf
    closes 23rd August: you have time to comment

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  • Fully agree with Rogue1 - if a patient has swapped to a digital practice then the previous practice should be fully entitled to refuse to re-register them (and with no questions asked by management).

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  • Re/registrations will be those who might actually need healthcare, again entrenching the difference in populations that the selective registration process started. 2 years to go!!

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