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The waiting game

Second private online GP provider looking to partner with NHS practices

Exclusive A second major provider of private online GP consultations is looking to offer its services via the NHS, Pulse has learned.

Push Doctor, which currently offers video GP consultations ‘in minutes’ at £20 each, told Pulse that it is seeking ways to provide NHS services.

Birmingham LMC chair Dr Robert Morley told Pulse that Push Doctor had ‘contacted all Birmingham practices’ in a search for partners who could use its technology.

The bid comes as fellow online provider Babylon Health is actively seeking to expand its NHS service offering elsewhere in the UK, having already signed up thousands of patients since its London launch in November.

Although Push Doctor stressed plans were in early stages, the company said it was seeking to work with multiple GP practices across multiple CCGs.

Founder and chief executive Eren Ozagir said: ‘As a category leader with unrivalled UK experience in delivering high quality regulated digital healthcare we continue to explore, with stakeholders at a local and national level, how we may work together to bring Push Doctor's unique levels of speed, availability and convenience to NHS patients and at the same time greater efficiencies in the provision of care.’

He said both the NHS and the CQC – which published a report on online providers last week – had ‘repeatedly stated the importance of digital in improving patient choice and the quality of care’.

But, despite this, Dr Morley said there was concern locally over what the plans will mean for GPs, adding: ‘It is a matter over which the LMC is liaising closely with the CCG and NHS England locally.’

At the same time, Babylon Health confirmed to Pulse that 'multiple talks’ are ‘going on with cities all over the UK’ about expanding the GP at Hand service beyond London.

GP at Hand has proved extremely popular, with 4,000 patients a month signing up since the November launch, but it has faced a backlash from GP leaders including the BMA, Londonwide LMCs and the RCGP.

Medical director Dr Mobasher Butt said: 'We're looking at sites all over the country. Obviously any of the major cities would be great locations.'

The comments come as board papers from NHS Hammersmith and Fulham CCG, where GP at Hand’s London host practice is based, had said Babylon Health planned to launch its NHS service elsewhere ‘in July 2018’.

GP leaders’ criticism has focused on current advice that the service model may not be suitable to certain patients, including those who are frail or pregnant, prompting allegations of ‘cherry picking’.

Although Babylon Health has refuted the claims, saying GP at Hand has patients from ‘across the ages from children, to people over 80, to people with complex health needs, NHS Hammersmith and Fulham CCG board papers said 'almost all of the new patients are in the 20-64 age group, with three-quarters under 35'.

Readers' comments (28)

  • Karen Morton

    I have to declare a conflict of interest here as I founded an online service which offers GP telephone and email consultations; and very importantly, access to gynaecologists by phone. My GP trainees have just changed over after 4 months with us. I barely had time to get to know them. They can barely have had time to touch the surface of O and G. How can they really provide good care in the community with such a short experience? I asked at the LFG 'Surely it should be extended back to 6 months?' but was told that women's health is not even compulsory. Is it small wonder that the most ridiculous referrals for next to nothing are made to the hospital and huge numbers of unnecessary scans are requested? This all costs a huge amount of money and wastes women's time and their employer's money. It almost certainly contributes to the Gender Pay Gap or as I call it, the Gender Career Progression Gap. Surely access to specialists remotely is the right thing, saving the face to face for when it's needed. It can be done safely and should be done.

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  • We’ve been told by our CCG that we have to engage in e-consult. My concerns are that is makes us available 24/7 and there is no extra money to deal with this extra demand which may reduce OOH/111 input. What about indemnity effect?

    Comments on AI - I think we may become supervisors/consultants with AI. Clinical examination can be invaluable and currently needs a clinician. I think e’re a generation away from any radical change here.

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  • Karen Morton 9.05pm

    I agree and would go further. All consultations should ideally be done by phone or Skype / Video link first in both General Practice and Hospital.

    Having been part of a referral management centre in the past, I also agree that many GP referrals appear to be inappropriate. However one has to look at the reasons for referral. Lacking the knowledge is NOT the main reason. Here are some other reasons:

    The patient wants a second opinion and sees the GP as a referral portal to real Doctors.
    The patient has multiple complicated symptoms that require a lot of time, something that GPs do not have. GPs are not paid directly for their time.
    Some GPs do not have access to certain scans...
    The patient has private health insurance
    Often GPs with the most knowledge refer more because they worry about rare conditions
    In the modern world of complaint culture many GPs worry about litigation. They too are inundated with what experienced GPs feel are inappropriate referrals from nurses, pharmacists, care homes. The threshold to consult has changed and we are all equally busy.
    It can be stressful blocking a referral that a GP knows is not required and can cause a breakdown in the Doctor / patient relationship. This can be less of an issue in secondary care where the respective patient may not be seen again.
    Being the last to hold the buck is not pleasant.

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  • Spot on Tony, combined with a decade of decreased funding in real terms and an end of days recruitment crisis to name but two of many negative issues affecting general practice.Any surprise we are in a death spiral.

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  • Karen Morton 9.05pm

    Another point: If your GP trainees spent most of their time doing Out Patient clinics while being supervised by seniors, rather than on the wards, they would have ample time to gather enough experience in four months. When I was in Canada, years ago, that was how GPs were trained.

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  • That's the problem with junior hospital posts, it is more about service rather than training - we would need more consultants for it to be truly consultant led and also more IT in hospitals. But the consultant job would be even more harder.

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  • could they stop sending them to A^E when they don't know what to do with them and the patient is registered but lives 100s of miles away. fed up of dealing with rashes that have been present for 4 weeks or more - not joking, sent to A^E by these companies rather than referred to a local GP service. patients are totally confused how to access services. mind you 111 is even worse.

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  • AlanAlmond

    Theres lots of expertise and plenty of good ideas on how things should be organised that to me is clear, the problem I feel is an absence of sensible coordination at the macro level. This is primarily because macro level coordination is in the hands of politicians with little understanding of basic science. Their primary concern is short term popularity, and they rely on home spun ‘common sense’ and the ‘advice’ of politically appointed ‘experts’ who often have expertise in completely the wrong field (Lord Darzi being a perfect example). It’s a consequence of the fact the NHS is funded out of taxation and it’s difficult to argue against political control of how the money is spent. We need to find a way to prevent politicians using the NHS as a popularity and vanity tool. The biggest problem the NHS has is the vanity and ignorance of politicians.

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