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GP at Hand costs could ‘jeopardise’ other health services if not mitigated

The costs associated with the Babylon GP at Hand practice could ‘jeopardise' other health services if not mitigated, according to the CCG which hosts the online GP service.

NHS Hammersmith and Fulham CCG said the 'exceptional' growth in the digital-first GP service list has led to increasing costs, which if not resolved could threaten other health and care services in the area.

Babylon GP at Hand also puts a 'significant administrative burden' on the CCG, the latest board papers said.

In response, Babylon - which currently has 40,000 patients registered with its NHS service - said 'any discussion around the need to accommodate a growing practice' is a matter for NHS England to 'resolve'.

Last month, Pulse revealed the CCG might not be able to 'pay its bills' due to financial pressures caused by tens of thousands of patients registering with the service. This came as the CCG reported a £2.5m cash deficit, with Babylon GP at Hand cited as the 'key driver' of the cashflow issues.

Hammersmith and Fulham CCG previously said it needed an extra £18m pot of funding from NHS England to cope with the number of patients. This led to neighbouring CCGs bailing out the CCG, with over £1m in funding.

At the same time, NHS England’s London regional team agreed to re-allocate funds from other London CCGs. However, some CCGs, including Tower Hamlets, Lambeth and Southark, have objected to covering the costs of patients residing within the CCG but signed up with GP at Hand.

At the time, NHS England assured the CCG the costs would be 'mitigated fully'.

But in the latest board papers, published today, Hammersmith and Fulham CCG said: 'The exceptional list size growth associated with the Babylon GP at Hand practice has resulted in increasing costs flowing to the CCG. 

'Should the mitigation not materialise there will be a material worsening of the financial position of the CCG, potentially jeopardising other health and care services in Hammersmith and Fulham.' 

A Babylon GP at hand spokesperson said: 'The needs of patients have to be put first which is why we have seen the list grow so quickly over the past year.

'Babylon GP at Hand receives no extended hours funding as a result of its growing list size, nor indeed any rent reimbursement for its clinics outside the CCG.

'Therefore any discussion around the need to accommodate a growing practice in the area is a matter for NHS England to resolve in line with the assurances they previously gave the CCG all in the interest of patient choice.'

The CCG is currently in talks with NHS England on how and when Babylon GP at Hand costs will be recovered.

The rise of Babylon GP at Hand

Babylon started offering online GP services as a replacement to regular GP practices across London in November 2017.

GP leaders expressed concerns about the impact of Babylon's entry to London, after it rapidly signed up tens of thousands of patients to it's GP at Hand app via the out-of-area registration scheme.

The service has also been criticised for ‘cherry picking’ patients, as it advised certain patients - including pregnant women and patients with learning difficulties - to ‘discuss’ whether it may be ‘appropriate’ to register with ‘a practice closer to home’. Although these restrictions have now been lifted.

Despite concerns, health secretary Matt Hancock said he is a patient of Babylon, and that the company is ‘taking the pressure off the NHS’.

An independent evaulation of the service is currently being conducted by Ipsos Mori, while the CQC is assessing whether the app has destabilised other GP practices, and its impact on the overall quality of care.

Meanwhile, GPs called on the BMA to abolish the out-of-area registration clause in the GMS contract - which allows patients to register with practices outside of the traditional GP boundaries - at the England LMC conference last year.

Readers' comments (6)

  • National Hopeless Service

    Out of area registration is going to go the same way that fundholding went. On the surface a good idea but too easy for a few to totally shaft the system and break it for everyone.

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  • Vinci Ho

    (1) ‘’A Babylon GP at hand spokesperson said: 'The needs of patients have to be put first which is why we have seen the list grow so quickly over the past year.’’
    Cunning .
    Cannot think of any word other than ‘populism’ . Manipulating populism disregarding the pre-existing deficiency of resources in general practice, is irresponsible, deceitful and despicable.
    (2) It remains Cherry Picking because one would know logically, those pregnant and elderly patients will always prefer to prefer a GP practice near home . Common sense .My argument is CCGs should pay these private providers a much less rate for registering these out of area patients. So , let them Peanut Picking , by all means .
    (3) The health secretary needs to declare conflict of interest by any standard , especially after he openly declared himself a patient of GP at Hand . This is indirectly, advertising a NHS GP practice? Somebody, please check if any legislation has been broken.

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  • Edoardo Cervoni

    "GP at Hand costs could ‘jeopardise’ other health services if not mitigated", and may I add: NOT ONLY. It may well jeopardise patients' care. Vinci Ho makes strong points on the topic.

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  • Bob Hodges

    Change Carr-Hill.

    We've been talking about changing the formula to better apportion resources to need/deprivation for years, but shied away.

    In one fell swoop it decimate Babylon's business model and help attract ACTUAL (not virtual) GPS to places of need.

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  • Just Your Average Joe

    Quarter the price per patient paid to online registrations, and recycle the saving into the helping practices loosing core funding which balanced their books.

    The work left behind by Baylon is all the patients with complex medical needs, the elderly and house bound.

    The 75% not paid should fund a service to help the housebound and elderly - taking some of this workload away from practices, which will otherwise be unable to function.

    The surgeries which lose the fit and young patients will slowly be destabilised and not be able to pay staff/locums and then won't have the resources to provide core functions.

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  • The Swedish system of individual risk based capitation fees would resolve this as well funding issues around the housebound, those in nursing homes and ‘patient drift’ of complex patients from poorly performing practices to their neighbours.

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