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GP at Hand expands to Birmingham with limited 2,600 list size

Babylon GP at Hand will expand its service to Birmingham tomorrow after the London-based provider received approval from Hammersmith and Fulham CCG in a board meeting today.

Board members from Hammersmith and Fulham Primary care commissioning committee assessed the expansion of the digital-first GP service and made recommended restrictions for the first three months, according to the latest board papers.

The restrictions initially restrict the number of patients that can register to 2,600, and there are limitations on the geographical area from which patients can register.

Yesterday, GP leaders warned as soon as the decision was made, GP at Hand could start business either ‘later tomorrow’ or on Wednesday.

Birmingham and Solihull LMC medical secretary Bob Morley said: ‘The intention is to approve it and I would’ve thought that GP at Hand would start business as soon as possible after that decision is made in the Board meeting. It could be later on tomorrow, it could be Wednesday I suppose. That is my understanding.’

The board papers also mention the restrictions for Babylon to put in place for the first three months such as limiting the patient list size to no more than 2,600 and limiting registration from patients living or working in the Birmingham City Council or Solihull Metropolitan Borough Council boundaries.

Dr Morley said it was understandable for Babylon to ‘get some structure’ at first, but that the restriction would be lifted as university students arrive to the city, which could lead to an influx of registrations.

He continued: ‘In all honesty, I think that’s something that they want in order to get some structure. My concern is that once that restriction is lifted, then we may well see a massive expansion in the number of patients registered and it looks like that restriction will be lifted around the time when lots of university students will be moving to Birmingham. One wonders the extent to which Babylon will indulge in some saturation advertising to get these patients registered with them.’

Babylon has said the limit on patient list size is so it can work with local NHS authorities to 'carefully' roll out the service. 

It said: 'This will ensure the best possible experience for our patients while de-registering from their existing GP practice. Anyone who misses out will remain with their existing GP practice and will have the option to complete their transfer from the beginning of September.'

Babylon has stated that the first clinic in Birmingham will operate at Badger Medical Centre but that it would be announcing more clinics in the area soon. Additionally, the digital provider said the service will be available to more patients across Birmingham as the catchment area expands.

The PCCC also highlighted some unresolved issues with regards to the access of community services and screening programmes and stated various objections to the proposed contract variation.

It says: ‘Management of access to locally commissioned community services such as IAPT. In London this has been a significant challenge causing delay to patients accessing care in their local area. In Birmingham this arrangement may have an even greater level of complexity to achieve access for patients.’

Dr Morley also stated his concerns of Babylon’s lack of relationships in places with secondary care providers.

He added: ‘The fact that the GP at Hand practice has got no relationships in place with secondary care providers or community providers in Birmingham, so how are they going to put in place the required pathway from referral, for example, for patients with mental health problems is anyone’s guess at the moment.

‘In terms of the patient demographic this practice will inevitably target, there are concerns about the number of patients with significant mental health issues could register and how those patients will be clinically managed.’

In response to the PCCC decision, UK Medical Director for Babylon GP at Hand Dr Matthew Noble said the practice in Birmingham is open to everyone, even patients with more complex needs.

He said: 'Many people have been used to waiting two or more weeks for a GP appointment. Babylon GP at Hand is loved by patients as they can often see a GP within 30 minutes, it’s valued by GPs who can enjoy flexible working, it helps reduce visits to A&E and it doesn’t cost the NHS a penny more, in fact it can save the NHS money.

'The practice is open to everyone - for those with more complex conditions who really struggle with everyday living, we have a care coordination team that has frequent contact to help them manage.'

Readers' comments (13)


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  • This approval and expansion is a concern for all UK gp practices with the potential to defund and destabilise primary care to its end. I echo the comments as to why a London CCG already in financial difficulties would be allowed to approve this expansion outside of its Jurisdiction. No doubt there has been discussions with NHSE around future unfair bailouts for the ccg being contingent on this approval in order to distrupt gp practices nationally. The absence of both the BMA and the RCGP whilst this is happening also stinks a d is suspicious. There is clearly a greater plan at work and watch the dominoes fall. The only way to fight back is for local practices to offer remote consulting however the tools (including the intentional non development of the NHS app for this purpose recently highlighted in the hsj) are not there. Practices don't have the ability to compete with GP at hand so watch the rush for a select selfish few practices to join the this disruptor service to safeguard their own survival. This with PCNs as a pointless distraction is going to irreversibly destroy UK general practice. But there is no concerted resistance from anywhere. V sad.

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  • You cannot allow one rule for practices and another for Babylon.
    This is either driven by management fear of Babylon's lawyers (which is cowardly, because the regulations are clearly on the CCG's side if it refuses to allow it); or DOH intervention because they don't believe in either general practice or PCNs and want to break the system; or perhaps someone somewhere stands to benefit somehow, perhaps with a nice cushy job or sinecure directorship in digital health in a couple of years.
    GPC, BMA, and RCGP should be very visibly opposing this - so where are they?

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