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GPs buried under trusts' workload dump

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)

  • Your website lists groups of people who should "discuss their needs with you". At that discussion, are they dissuaded from joining? If not then why bother having them phone you at all? If so, you are doing something that most GP's are simply not allowed to do. Hence you are robbing the system of healthy patients to turn a profit.

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  • Ermmm....85% of GP consultations do not require a patient to be examined?!??! I think not somehow...

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  • I certainly remember going to medical school to train to speak to people on the telephone and via videos examine them to make a good diagnosis. Might as well train others to do that job. What was it we used to say if you don't examine patients you make mistakes but not in such good language !

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  • What I don;t understand is how a National health service talks about competition between Practices... If this is an Universal, free for all Primary care service, shouldn't the Government make sure that all Doctors can provide the same standard of care??
    Otherwise we are talking about a Subcontracted Private Primary care...

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  • Don't know what level of illness they are seeing to make this claim but an extremely small % of my consultations could be properly handled without face-to-face contact and for those there is the telephone and email. A more useful statistic would be what % of consultations carried out using the app actually needed GP involvement in the first place.

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  • Jmd

    Real concerns.
    85% - where is the validation, the pilot study for outcomes?
    I feel Dr B has wearing a cap of a business model( profiteering) and medicine and health is not.
    The time it takes to have a phone or video consultation is no less then F2F where a Dr can assess and carry out vital examination of all parameters needed.
    How are you going to assess sepsis, unwell child on a phone or video etc.
    It appears that Babylon will cream off easy pickings and leave the harsh reality of medicine to GPs. This culture by Babylon will encourage the ‘worried well’’ and reinforce it further.
    Why not invest this money locally and let the local GPs decide on a model. This will encourage a degree of continuity and also local GPs will be aware of the socio economic of their patients.
    I am also afraid that there will be more referrals to 2ndry care as no Dr in Babylon will risk their careers for missing an important diagnosis.
    What may be fruitful is for GPs to plan on a model of working shift work with extra resource for patient contact.This will cater for late and early consultations thus removing the need of the private sector.
    Under Babylon system, how are they going to distinguish patients entitled to NHS provision- we will be opening flood gates for tourism health!

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  • Even if the 85% is correct , which I doubt. This is self selecting population quite different in its characteristics to the ordinary GP population.

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  • Definition of ‘virtual’ : being as specified in essence or effect though not in actual fact, form or name. That says it all.... enough said!

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  • AlanAlmond

    PULSE : proud sponsors of Babylon health. Working together for a crapper tomorrow

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  • Butt is clearly talking out of his Butt!!

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