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GPs go forth

CCG needs £18m in extra funding to cope with GP at Hand patient influx

The CCG hosting GP at Hand has said it will need an extra £18m in funding from NHS England this year in order to cope with patient numbers.

NHS Hammersmith and Fulham CCG asked for an in-year injection of funds in March, after calculating the extra cost of hosting GP at Hand - which is run by Babylon and allows NHS patients the chance to speak to a GP online within 48 hours - would be £10.6m in 2018/19.

The new higher figure was unveiled in board papers published by today, and comes as NHS England is still deciding whether to top up the CCG's funding allocation.

Dr Jefferies and Partner - the GP practice which hosts the GP at Hand app for NHS patients across London - has over 26,000 patients currently. Before the launch of the app, the practice based in Fulham had just 4,000 patients.

Board papers said NHS Hammersmith and Fulham CCG was hoping to end 2018/19 with a small surplus.

But they added: 'The plan requires £18m of external support from [NHS England] to cover the GP at Hand accelerated costs.'

And the CCG said that the extra funding is ‘expected but not confirmed at this point’.

The papers quoted CCG managing director Janet Cree as saying that 'progress is being made' on the discussions about extra funding.

She said there was 'likely to be an agreement with NHS England on some financial support to the CCG within this financial year'.

It comes as GP at Hand recently told Pulse that 40,000 patients have applied to join the service.

And Pulse revealed earlier this year that a new patient signs up with the service ‘every two minutes’, amounting to 4,000 new patients a month.

A GP at Hand spokesperson said: 'GP at Hand reduces pressure on other NHS services and budgets. This is achieved by making NHS GP appointments available 24/7, typically within two hours of booking, even though funding through the GMS contract covers only Monday to Friday core hours.

'The reality is that people across London are exercising their rights to choose their NHS general practice. In less than six months, over 40,000 people have chosen GP at Hand, whose registered list is based in Fulham.

'This, of course, means that [NHS] Hammersmith and Fulham CCG’s budget will need to increase as they commission services on behalf of more people. Balancing this, CCGs with fewer registered patients going forward will also see changes in their budgets.'

The CCG papers further updated the board on the progress of plans for a full evaluation of the rollout of GP at Hand. 

CCG leaders said they met with NHS England ‘to consider the bids to undertake the independent evaluation of the GP at Hand service’, with a successful bidder to be announced shortly.

NHS Hammersmith and Fulham CCG launched a bid in March worth £250k to hire an ‘independent evaluator’ to assess the ‘outcomes and impacts’.

Accusations of 'cherry picking' patients has riddled GP at Hand since the London launch, including from the BMA, LMCs and the RCGP.

Most recently, Doctors in Unite warned health secretary Jeremy Hunt that the model 'threatens the model of general practice' by 'hoovering up' younger, fitter patients.

GP at Hand has denied turning away certain patients, but its website says that patients with frailty, dementia, pregnancy, drug addiction, learning disability and complex mental health problems may be advised to register with a practice closer to home.

March CCG papers said 'almost all of the new patients are in the 20-64 age group, with three-quarters under 35'.

Babylon, the company behind the app, has hit back at criticism by saying patients ‘have the right to choose their NHS practice’.

Readers' comments (12)

  • Vinci Ho

    ‘Worry not the presence of poor resources, worry more the way resources were distributed.’

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  • Vinci Ho

    Another issue is aggravating the inter-generational conflict(old versus young)

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  • More access means more funding is needed. Patients have always been receiving rationalised health care and to pretend they are not is just foolish. They have opened the flood gates and need more money now. NHS England did not see this coming. Now they need to put money where their mouth is or give some reason to scale down or stop the service.

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  • NHS funds to CCGs is supposed to be population based. Has something changed? NHSE is manipulating cash to independent CCGs in a variety of ways. Our CCG lost £4million as NHSE wanted the cash for hospital deficits. Independent? Ha!

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  • The Government has allowed this to happen. Is it incompetence or is there an ulterior motive?

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  • Charles Richards | GP Partner/Principal08 May 2018 3:49pm

    Nothing's changed but funding doesn't follow the actual population today - there is always a lag (I'm told about 3 years) between actual population and estimated population on CCG funding.

    They might have gone bust by than :)

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  • AlanAlmond

    Spokesperson ‘The reality is that people across London are exercising their rights to choose their NHS general practice. ‘
    No people don’t have a ‘right’ to anything they want. No one has a right to draw limited funding away from people with complex health needs. No one has a ‘right’ to consult online. The people of Birmingham aren’t being offered this ‘right’ and yet they pay the same taxes. Why do a small group of 20 something’s have this ‘right’ when no one else does? The NHS is a resource limited tax payer funded service and no one is anymore important than anyone else. That apples to Londoners just as much as anybody else you deluded self important fool of a spokesperson

    Push Dr isn’t a right. To suggest so is dumb five times over.

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  • AlanAlmond

    GP at hand...not push all,the same anyroad only one is straight up honest and privately funded. The latter is screwing the tax payer to provide unproven health perks to the usually fit and healthy. And they sleep easy, I’m sure they do.

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  • The answer is for all London practices to restrict their practice boundaries to 10m from their front door.
    Then tell patients they have to consult online first before they will see them.
    And also let all the frail, housebound, nursing home, learning disability, personality disorders, psychiatric patients know that the service is not suitable for them.

    This service is an arbitrage play for unbalanced funding that historically rewards good practices with an excess of complex and housebound unfunded patients.

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  • I think we all need to flag the bad medical practice we see sometimes from online services..maybe at GMC level...I think we all have examples of this...

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