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Independents' Day

GPs issue warning as London practices lose young patients to GP at Hand

Doctors in Unite has urged health secretary Jeremy Hunt to put a stop to the expansion of GP at Hand, the online GP consultation app registering NHS patients across London.

GPs in the union said GP practices in the capital are seeing their list size 'shrink for the first time in years' as a result of the app's expansion, which is destabilising them financially.

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

Reiterating claims that Babylon attracts 'younger, fitter patients', Doctors in Unite chair Dr David Wrigley said the scheme's 'hoovering up' of such patinets 'threatens the model of general practice'.

In a letter to the health secretary, Dr Wrigley said that usually, '70%' of a practice's list is made up of relatively healthy patients, which 'subsidises' care for the more ill patiens.

But Dr Wrigley claimed that GP at Hand 'targets the most profitable patients – those who are younger and healthier and don’t need extensive care from their GP'.

He said there was therefore 'no doubt' that 'GP at Hand will financially destabilise many practices robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients'.

He concluded: 'Jeremy Hunt has said that general practice is the jewel in the crown of the NHS. If he truly believes this, he will acknowledge that the GP at Hand model thr1eatens the very survival of NHS general practice.

'GP at Hand has made it clear it wishes to roll out this model of care across the country, so this scheme will threaten general practice across England.' 

Pulse reported last week that Babylon now has 200 GPs on its roster and is processing applications that would take the number of NHS patients to 40,000.

What Babylon says

A GP at Hand spokesperson told Pulse: 'People have the right to choose their NHS practice. GP at hand is an NHS service; paid for by the NHS; providing NHS services to all patients – just like the vast majority of GP practices throughout the UK.

‘In less than six months, over 40,000 people living or working in central London have applied to join NHS GP at hand, with more than 4 out of 5 people rating our digital appointments giving them the full five stars.

‘Babylon has a sub-contract with the GP at hand practice, which receives the same funding from the NHS as the vast majority of NHS practices do. Capitation funding - the so called “global sum” - varies from below £35 per 15-44 man registered with a practice to over £190 for each person over the age of 85*.

‘The reality is that patients and GPs are flocking to GP at hand because they recognise the potential that high quality, digital-first 24/7 NHS GP services bring.

‘The 200 GPs who have already joined Babylon do so because they are treated with respect and not put under the levels of pressure all too common in other practices. 95% of babylon doctors surveyed say: “Usually, I can manage the amount of my work well”.

‘In comparison, the BMA showed in 2016 that 84% of GPs across the NHS reported that workload pressures are either “unmanageable” or “excessive” and having a direct impact on the quality and safety of the care they deliver to patients.

‘Both Londoners and GPs clearly like GP at hand, which as a free-at-point-of-need NHS service, extends 24/7 primary healthcare access to more members of the public.’

Readers' comments (6)

  • the intersting thing is what happens to patients who have easier access.

    A US paper on Virtual/ Remote care suggests that improved access increases demand!


    Evidence of increased utilization over time: As shown on the right,
    members who have had access to Teladoc for longer periods of time
    use the solution more frequently than those who recently joined: the
    utilization rate for users onboarded in 2013/2014 is nearly twice as high
    as for the recently onboarded 2016 cohort. This virtual care model,
    therefore, is not just a “flash-in-the-pan” offering but a product that gains
    momentum over time.

    This is the sting in the tail for funders of Babylon etc!!

    Access breeds Excess!!

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  • Dear All,
    Reducing the effort required to access free healthcare to a swipe of an icon on your phone will result in increased healthcare seeking behaviour. The business model for this, when the income is approx £30 per quarter, is going to be very interesting.
    Paul C

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  • I agree with Paul Cindy! This strategy of targeting “ easy” fit patients will destabilize “traditional” General Practice model and appeal to young adults in Metropolitan areas! A multi-tier Service will become more obvious and destabilize Primary Care planning and encourage large Primary Care settings! NHS planning will encourage this development.

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  • The business modelling around this needs aspects from Babylon, but also demands a review of business planning from other affected practices, from affected commissioners of 1ry care, providers and commissioners of community services, and from the NHS as a whole.

    Whilst this organisation may be loss-funding this program for 'data gathering' or 'market busting', contingencies need to be built to prevent an evermore predatory approach to the UK treasury. At present it seems that the break point is the Health dept as even 'NHS' funding seems unable to use its structures to regulate funding to organisations set up with a predatory manner. The structures seem to be effective only for 'traditional' organisations, or 'gentlemanly conduct'.

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  • The thing is that young people, if they ever went to a GP, do not see a GP get up out of their chair and examine them. Nor understands the importance of a relationship and contact is in a consultation. But since most GPs are part time, and are glued to the computer screen, it is not surprsisng to me that younger punter takes up the lazy option of using GP at Hand. Do not even have to get out of bed to use it. Of course it will be popular, until patients are ill.

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