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Virtual consultations can be used in '85% of cases' says Babylon's top GP

Virtual GP appointments can be used to deal with ‘about 85%’ of all consultations, the medical director of online service Babylon has claimed as he is named the most influential GP in the UK by Pulse.

In an interview with Pulse, Dr Mobasher Butt, the lead GP at private firm Babylon which also runs NHS service GP at Hand, also said video consultations could help put a stop to practices closing in areas of the country that find it hard to recruit GPs.

Meanwhile, he suggested it was no longer possible for GPs to provide continuity of care throughout a patient’s lifetime – and that digital consultations instead offered a way to see the same GP for specific episodes of care.

Pulse spoke to Dr Butt ahead of him being named number one on our annual Power 50 list of the UK’s most influential GP leaders, revealed today.

Dr Butt was placed in the top spot of this year’s Power 50 after GP at Hand’s launch forced NHS England to rethink its allocation of general practice funding, leading to proposed changes to the GP contract.

Dr Butt’s influence has also increased following the arrival of a pro-technology health secretary, Matt Hancock, who is a patient of GP at Hand, and has reportedly described it as ‘brilliant’.

However, the GP at Hand service has been criticised by some parts of the profession for cherry-picking patients and destabilising the general practice model.

Dr Butt described the launch of GP at Hand, in November 2017, as a ‘landmark’ moment.

In the space of nine months, the NHS service – formed through a partnership with west London practice Dr Jefferies and Partners – has signed up 30,000 patients from across London.

Dr Butt reiterated that Babylon wants to expand the GP at Hand service further, across the UK, and that his team is in discussions ‘with tens of practices’ about setting up partnerships.

Increasing the number of online consultations would help ease pressure on understaffed GP practices – and could stop them from closing – he said.

‘We know about 85% of cases can be dealt with entirely via virtual consultation,’ he said, adding that this assessment was based on ‘hundreds of thousands of patient records’.

‘What that means is you can potentially deliver care from a different location but then have a smaller number of GPs who are in that population to actually do the physical care that’s needed – that really helps make sure surgeries don’t close in areas that really need them but where people are struggling to get GPs into jobs,’ said Dr Butt.

When asked about how GP at Hand could provide continuity of care for patients, Dr Butt said this was possible because the service allowed patients to book with the same GP.

However, he added: ‘The idea that people have one GP from childhood through to adult life is sadly something that just isn’t true anymore.

‘What’s important is that for certain episodes of illness you have continuity of care, so if you develop depression someone looks after you from the first consultation through to you being stable.’

Pulse also asked how far the introduction of GP at Hand had created a level of competition between practices that had not previously been seen in the NHS.

Dr Butt said: ‘You’ve already got large groups, federations, who might be competing with singlehanded GP practices. It’s an even playing field… there’s nothing about the launch of GP at Hand that precludes anyone else from forming similar innovative solutions for their patients.'

Defending GP at Hand against criticism that it selects healthier patients, Dr Butt said the service ‘simply can’t pick patients’.

‘NHS England, at the start of GP at Hand, advised that for certain patients group it would be advisable for them to make sure that they understood the service before signing up. 

‘These categorically are not exclusion groups and it’s very clear on our website that they’re not exclusion groups.

‘What we’ve seen is quite the opposite, we’ve seen patients with complex care needs present to our service, where actually this is a fantastic service for them because it offers them fast access without having to leave their home.’ 

Critics of GP at Hand have also claimed it destabilises the general practice funding model, because it leaves other practices without younger, fitter patients - the funding for whom is used to cross-subsidise older, sicker patients who require more care.

But Dr Butt said the profession should be looking to change the way funding is allocated instead of trying to ‘thwart’ innovation.

‘If we have problems with the funding formula then we should all work collectively to think about how do we fix the funding formula, not start saying let’s try to thwart innovation in some way,’ he said.

 

 

 

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Readers' comments (32)

  • Bullshit

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  • Do you think he has ANY insight as to the unintended consequences or downsides at all??

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  • How does he know that 85% of cases can be dealt with entirely via online consultation? Was this data in a peer reviewed journal that i missed?
    10 years from now is everyone going to have an online consultation with 111 who will then decide if the patient should see a real doctor who can examine a body? How will these doctors be trained if they have not examined hundreds of normal bodies to start with? What is the Endpoint of all this? How can a profession make its skills seem so worthless? It looks easy because it has taken years of practice. Time to go private and then patients can choose who they want to see.

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  • Vinci Ho

    One interesting feature about this whole story is the emphasis of the number of patients registered as a measure of success for instance, 30,000 in short space of time . This is based on the assumption that the more on-line appointments provided , will absorb more patients. Hence , increasing more investment in providing these appointments is the way forward .
    But since this is consistent with an economic model with heavy dependence on utilities, the law of diminishing returns (or diminishing marginal returns) will at some stage apply. Only time will tell if this new direction of travel is worth pursuing. Obviously, there is a presumption that these appointments are problem-solving( hence, an endpoint) productive in majority of the cases , for instance , 85% .
    My another question is whether somewhere down the road , will there be any bottleneck , short term or long term , to be identified in this set-out to be efficient process of generating appointments?
    Clearly, continuity of care , which is an unmeasurable quality , is to be removed from this equation of outcome assessment.
    Well , interesting time with all kinds of extraordinary signs.....

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  • The influence of a sales rep lasts as long as there is a 'mark' who wants what is being sold. The 'Hancock' is and ideal mark, deluded and in need of shiny wares to 'impress' others.

    His civil servants are happy to support the 'rep' at present, as he serves their purposes; to depower the medical profession and ensure that they are in charge. Unfortunately they don't quite realise that without the medical profession there is no health service to be in charge of.

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  • Just Your Average Joe

    85% of consultations dealt with on-line - with anything difficult told to go re-register with a real GP who can see you.

    Told you dealt with on-line.

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  • Let common sense prevail

    In other words, 85% of consultations are trivial stuff that doesn't need to see a GP, and yet we are spending billions of pounds funding them.
    Why don't we start an app entitled 'Askyourgran' and employ an army of unqualified people who have a bit of common sense. May be a little cheaper.

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  • I hope this statistic is not an example of believing your own hype.

    The paid for opinion piece submitted to the ccg to justify expansion by this organisation was not an effective smokescreen. It merely stated its assertions as above, then justified them by saying that some people (slightly more than 5) on facebook gave positive reviews.

    If you want to make up stats, at least make them believable!

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  • Vinci Ho

    Well, the fever of apps is phenomenal, even the Swedes are trapped.
    ‘Contraception app advert banned by UK regulator’
    https://www.bbc.co.uk/news/technology-45328965

    Sign of the times

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  • Vinci Ho

    And as I wrote yesterday, the sanctions or penalties in certain misbehaviour of these providers are relatively tame , as far as the current legislations are concerned. I was referring to leaking or abusing users’ big data after the fiasco of FaceBook-Cambridge Analytica-VoteLeave.
    Well , tame sanctions also apply to this making a false claim on advertising. Natural Cycles app is likely to get away unscathed.

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