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GPs go forth

NHS has 'a lot to learn' from 'phenomenal' Babylon model, says RCGP chair

The NHS has ‘a lot to learn’ from Babylon’s ‘phenomenal’ GP at Hand app, the chair of the RCGP has said.

According to Professor Helen Stokes-Lampard, GP leaders did not see the ‘disruptive innovation’ coming. However, now that it is here, the NHS has to respond by rolling out similar technology across general practice as a whole.

She also suggested the model via which GP practices are paid needs to change, in order to protect practices from being destabilised.

GP at Hand uses the GP out-of-area registration scheme to sign up NHS 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.

Professor Stokes-Lampard told delegates at a King’s Fund conference in London: ‘GP at Hand - disruptive innovation at its most disruptive at the moment. Phenomenal technology, phenomenal business mind behind it, actually some very good clinicians, some great training for the doctors who work in it.

‘An amazing model in fact, they look after their GPs well. There is a lot we have to learn from.’

But, reiterating allegations that GP at Hand ‘cherry picks’ young and healthy patients, Professor Stokes-Lampard said this destabilises other GP practices because their funding is based on an ‘ethical compact’ whereby they are given ‘a modest amount of money for everybody, with a very modest uplift for the most weak and frail and vulnerable’.

She added: ‘Therefore if some people cherry pick the healthy and the well, then inevitably those who are left to look after those who are very expensive are doing badly.’

And she said: ‘This is a huge warning and if you're not aware of it, you need to be because there are practices now being destabilised.’

According to Professor Helen Stokes-Lampard, NHS general practice needs to act in response, with the RCGP involved in ‘lots going on behind the scenes’.

She said: 'So you have to do one of two things. You've got to totally adopt that technology, right throughout the NHS for everybody so it destroys the business model and it is normal across the whole of general practice - tech tsunami stuff. Or you have to tear up the financial model by which we pay [GP practices].’

She added: ‘One of those things has to happen fast. I would suggest we need to do both. It's really difficult to do, difficult conversations are happening…

‘It's very stressful for those practices who are now really feeling the pinch and we're absolutely on it.’

Professor Stokes-Lampard clarified to Pulse that she was not suggesting GP at Hand should be rolled out across the NHS.

Instead she said: ‘New technology needs to be expanded. We need equitable access to innovation technology across the NHS.

‘When you have a new provider coming in, who is only prepared to look at certain sorts of people, who by definition are fitter and more healthy than the rest of the population - you are unfair to the majority.

‘So what I want is the whole of the NHS to adopt innovation, to adopt new ways of consulting.’

Her comments come as GP at Hand continues to expand it list size with over 30,000 patients signed up to the service as of the end of last month.

A Babylon spokesperson said: 'We are very pleased to hear Helen Stokes-Lampard’s supportive comments. Helen has long championed the power of technology to support GPs.

'Patients and doctors are flocking to GP at Hand because they recognise the potential that high quality, digital-first 24/7 NHS GP services bring. The hundreds of 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...

'NHS practices receive six times more funding for each 85-year-old woman than they do for a 15-44 year old man. But much more important is the founding principle of the NHS - a universal service, free at the point-of-need. That’s why GP at Hand is available to everyone, young or old, in good health or not, and we provide appointments 24 hours a day, seven days a week. People are choosing GP at Hand, never the other way round.

'We look forward to working constructively with the RCGP and indeed everyone who is committed to great services for patients and fulfilling roles for clinicians.'

The patients flocking to use GP at Hand

Since November, Babylon's GP at Hand service has been signing up NHS patients from across London by making use of the out-of-area registration scheme.

Patients have signed up at a rapid pace, with 30,000 registered to date and a further 20,000 applying. However, south west London CCGs have said a fifth of patients switched back after joining.

The main concern from GPs has been GP at Hand’s ‘cherry-picking’ of young and healthy patients, which they say leaves other practices to care for patients with greater needs.

The service does not block anybody from using the service, but has suggested people who are frail or elderly (or pregnant or have severe mental health issues) may be advised they are better serviced by a local practice.

The GP at Hand model is still pending an evaluation which has been commissioned by London commissioner NHS Hammersmith and Fulham CCG, where Babylon's NHS host GP practice is based.

Ipsos Mori recently won the the £250k bid to review the service's ‘outcomes and impacts’.

Readers' comments (39)

  • ‘NHS practices receive six times more funding for each 85-year-old woman than they do for a 15-44 year old man.’


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  • Perhaps H S-L's comments were a little premature.....the Pandora's box of inevitable medico-legal claims hasn't yet been opened or filtered through yet.

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  • NHS practices receive six times more funding for each 85-year-old woman than they do for a 15-44 year old man.
    This sentence is nothing but playing with words and absolute Bullsh--
    I agree that 85 + year patients are weighted at 6 times as compared to 18-40 years but money doesnot increase because if that sentence was true then we should get 85 £ per every patient who is 18-40 and then 530 £ for every 85 tears old ,but does not happen.

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  • 'NHS practices receive six times more funding for each 85-year-old woman than they do for a 15-44 year old man."

    So the man who took over Hinchingbrooke hospital while CEO of Circle, now given another shoe-in by NHS England as CEO of Babylon, has no clue how NHS General Practice is funded.

    Is this ignorance, or meant to be deliberately misleading? I've heard it quoted repeatedly, which suggests the latter.

    The worst aspect of these disruptive innovators is that they think chaos is great and so are wilfully blind to the damage that their greedy business models inflict.

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  • I am sorry but this is a complete and utter betrayal.

    please hang your head in shame! HSL, please go and join Maureen and Clare.

    please look at Dr Murphy's tweets about babylon. They are destroying general practice. how dare you call them phenomenal. I think that a GP sat in a practice tending to his patient cradle to grave night and day is phenomenal.

    I have never ever in my entire life span met a clinician on the ground that would call them phenomenal.

    Professor Lampard, I think that you need to reflect on your choice of words.

    I am speechless and incensed.

    - anonymous salaried

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  • some consultancy post down the road for someone leaving office?

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  • I would love to cherry pick and just see nice and easy young patients who actually can recover and has less clinical risk but who is going to see the elderly with complex medical problems and polypharmacy? Maybe the Professor would instead of working at the college seeing nobody.

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  • I hope her words have been taken out of context

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  • Food for thought: Would any medical student be admitted if at interview they were to say I want to be a doctor so I can make unworkable rules and increase the risk and paper work for everyone and work in the GMC, colleges and the CCG and I do not want to see any patients.

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  • Unhelpful comments - it is not a good business model - it is for the company but not for the NHS and patients

    Unless they take an equal amount of elderly and offer services as we do in general practice - it is not right

    Or all practices use the It solution and insist on all patients are seen via the app first.

    The funding has to change - you cannot be paid £130 for an 85 year old.

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