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GPs go forth

NHS England denies direct involvement in Babylon's GP at Hand app

NHS England has denied involvement in private company Babylon’s drive to sign up NHS patients to its GP at Hand app, after GP leaders questioned comments made by its chair.

Speaking at an event hosted by Babylon and attended by Londonwide LMCs, NHS England chair Professor Sir Malcolm Grant referred to GP at Hand - which promises an online consultation with an NHS GP within hours - as 'the experiment that we have been conducting in London'.

But, clarifying the comments, an NHS England spokesperson said it had merely been involved in the commissioning and assessment of GP at Hand.

Speaking at Wednesday evening's event, Professor Grant said: 'The model that we have been working on in London, GP at Hand, I think is a very interesting pilot.'

And he said that NHS England has 'paid very close attention to what [Babylon] has been doing, and what other companies have been doing' because he thinks they are 'at a tipping point in the way in which we will provide care'.

But, referring to concerns raised by GPs about the model, he added that NHS England had to be 'desperately clear so we do not end up driving GPs out of practice and seeing this as an Uber-style rival'.

Instead he suggested it could be 'something that can supplement, can support and can ease some of the burden of practice'.

He added that NHS England will shortly be publishing a consultation paper on digital-first medicine. This comes as Ipsos Mori recently won the the £250k bid to review the service's ‘outcomes and impacts’ on behalf of NHS Hammersmith and Fulham CCG.

Since November last year, GP at Hand has used the GP out-of-area registration scheme to sign up over 30,000 patients from across London and beyond to a GP practice in Fulham in south west London. Patients are promised an online GP consultation within hours, and a next-day face-to-face appointment if required at a number of London hubs.

But GP leaders including the the BMALondonwide LMCs and the RCGP have raised concerns about the app's 'cherry picking' of fit, young and healthy patients.

GP at Hand does not block anybody from using the service, but says people who are frail or elderly, pregnant or have severe mental health issues may be advised they are better serviced by a local practice, and according to Babylon NHS England is behind this.

'To be prudent during the early phase of the rollout, the NHS has suggested that the service may however be less appropriate for people with the conditions and characteristics listed below,' the GP at Hand website says.

Londonwide LMCs chief executive Dr Michelle Drage said: 'GPs are meticulously careful about change because patient care and holistic care is too precious to meddle with without evidence of benefit. They would expect NHSE and commissioners to be equally cautious and impartial.

‘After seeing [this] presentation, we continue also to have significant questions about how and why a service such as GP at Hand, which undermines the financial model of NHS general practice, has been able to launch without any assessment of financial impact. And we call for transparent assurance of such new tech, operating outwith existing provision.’

Asked by Pulse to clarify Professor Grant's comments, an NHS England spokesperson said that NHS England's only involvement has been as part of Hammersmith and Fulham CCG’s GP at Hand 'clinical assurance' group, as well as working with the CCG to commission the independent review by Ipsos Mori.

A GP at Hand spokesperson declined to comment.

Speaking at a conference last week, RCGP chair Professor Helen Stokes-Lampard said the NHS has ‘a lot to learn’ from Babylon’s ‘phenomenal’ GP at Hand app, which she said was 'disrupting' general practice.

Readers' comments (13)

  • Surely this is obvious now - with the media humiliation of GPs.

    There is a motive to run primary care into the ground to clear the way for private medicine.

    Let's just get it over with. I would like embrace private medicine. I cannot wait to put up a sign stating 15 minute consultations are £50.

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  • National Hopeless Service

    Does indirect involvement make it anymore palatable?

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  • Vinci Ho

    Whether you like it or not , this is politics . Only the one with political wisdom and sensitivity can triumph . Good luck , Helen .
    It is all about political circumstances, if Stevens and Hunt dare to say ‘we need services like GP at hand’ , so be it . More GPs will leave and they can bear the responsibility of killing off NHS at the age of 70 plus by wiping out non-AI (hence, human) GPs as the gatekeepers.

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  • Come now, RCGP chairs dont last long - who would turn down a nice 6 figure consultancy/ directorship to blow the trumpet for a deep venture capital funded private company?

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  • 'desperately clear so we do [[not]] end up driving GPs out of practice and seeing this as an Uber-style rival'
    Uber got banned for,.... what was it.....
    "For much of the hearing, Chief Magistrate Emma Arbuthnot seemed unconvinced - Uber had shown a gung-ho attitude, determined to grow its business come what may."......perhaps an US attitude coming to an NHS outlet near you?

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  • Suggest you do FOI on when the leadership and directors of NHS have met Babylon in the last year and for notes of the meeting.

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  • I really can't see why some people feel that this is the death of general practice. This will only drive UP the demand for face to face consultations. The app may be as good as a GP in coming up with differential diagnoses when faced with an accurately defined set of symptoms - but how often does that happen in real life?
    And what about clinical examination? And what about psychosomatic illness? And what about intractable symptoms etc. etc.
    The only thing GPS need to worry about is how we're going to handle the extra demand.

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  • 20 years ago the system was changed so that GPs could not take a patient off their list, except in exceptional circumstances.
    Now we have a system that enables a practice to indirectly reject the majority of patients who have more than transactional needs.
    We now know that social determinants of health and continuity of care are critical but GP at Hand encourages a focus on the biomedical.
    We now have a practice, that to a great extent, ensures that to those who have, will have more.
    We have a great confusion between Babylon and GP at Hand, exacerbated by the company. Babylon and e consult and harry longmans systems brilliant and transformative to General practice and secondary care. On the other hand, GP at Hand indirectly discriminating against the vulnerable in society and reducing the support to patients to basic biomedical transactional medicine.
    Sad to see all those senior leaders attending the Babylon party not understanding the difference, the very leaders who have allowed primary care to fall and close across the country. Primary care is not perfect and needs transformation although On IT clinical systems the hospitals are way behind. If you lose the essence of service to small communities out of hospital, as you see in primary care, the cost both in holistic care, health outcomes and money will be immeasurable. The five year forward plan understood this. It expressed the importance of supporting patients to have and manage their care in the community and was as revolutionary as the 1948 Act. But then the Five Year Forward view has all but been abandoned by the very leaders who party with GP at hand.

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  • I've looked after 2000 patients for 25 years, thats 50,000 patient years now. Over that 25 years if I had been allowed to deregister just TEN people, my working life would have been 10% easier and the other 1990 people would have got better care.
    Babylon and NHSE have ripped up the rule book that the rest of up have to play by.
    How's abouts we each get to nominate 10 punters for the super AI to take over?

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  • Dear All,
    Would he like to comment on their lie about GPs receiving 6 x times as much income for 85 year olds vs 15-44 year olds, whereas in fact we all get the same global sum payment for them no matter what their age or sex?
    Also, i thought we had to offer same day appointments; "and a next-day face-to-face appointment if required at a number of London hubs."
    Are they getting special treatment? (thats a rhetorical question).
    This is the disruption Mr Hunt and his acolytes wanted, lets hope they've planned for the long term consequences.
    Paul C

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