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The waiting game

'Uber-style' private GP appointment service primed for national rollout

A new private GP company offering ‘Uber’-style GP appointments is preparing to roll out the service across the whole of England after a successful pilot in two north London boroughs.

The Doctaly service doesn’t employ GPs itself, but is the first reported service to match NHS GPs to patients who are prepared to pay a fee to avoid the usual wait to see their GP.

The GPs will see patients in their own practice and in their spare time, the company says.

But GP leaders warned they are ‘very concerned’ about the service, which they said would destabilise general practice and undermine the NHS, and encourages ‘queue-jumping’ for patients who can afford it.

Doctaly has been running for the past month at 10 practices in the London boroughs of Barnet and Enfield, with around 50 GPs signed up to offer appointments at various times.

The service is not yet available as an app, with patients booking appointments through the Doctaly website.

But the company has been likened to Uber – an app that allows customers to book taxis – because it does not employ the GPs directly, instead providing them with the framework to offer the appointments and then taking a cut of the fee.

Doctaly told Pulse that having proved the concept could work – with both patients and GPs keen to sign up – the service is now being rolled out with the aim of reaching the rest of London by the end of this year and the whole country by 2018.

Company founder Ben Teichman insisted the service is not about queue jumping but ‘quite the opposite’.

He said: ‘Doctaly is essentially a hybrid service between the NHS and existing private practice making private appointments more affordable, thereby opening them up to a wider audience.

‘It is not about queue jumping. Quite the opposite in fact. It should help drive queues down in surgeries and also take traffic away from A&E. An A&E appointment can cost the NHS £150 and if access wasn’t an issue, many of these patients could have been successfully treated by a GP.’

He said that the service was a ‘lucrative and convenient alternative’ for part-time GPs, and even full-time GPs who may ’want to do a few appointments on their admin day if they’ve got time’.

But Dr Jackie Applebee, chair of Tower Hamlets LMC in east London and Doctors in Unite representative on the GPC, said the service was ‘very worrying’ and would ‘further destabilise general practice’.

Dr Applebee added: ‘This is not the answer to the crisis in general practice. I acknowledge that access is a problem, but the fault for this lies at the door of the Government who have disinvested in general practice for years so that we now have an unprecedented workforce crisis.

‘This sort of service is the slippery slope towards privatisation of the NHS. It introduces the principle of topping up NHS services with purchased services if one has the disposable income. If the more affluent begin to do this in significant numbers it is only a small step to an insurance-based health service.’

GPC deputy chair Dr Richard Vautrey said: ‘Patients want and deserve a properly funded NHS GP service, based on the registered list, so they can get appropriate timely access to their local GP and that practices have the resources and capacity to offer this.

‘While patients can access and pay for private GPs or consultants, the risk is a more fragmented service and patients having remote consultations with doctors they don’t know and who won’t have full access to their NHS medical record.’

How ‘Uber GP’ appointments work

Ben Teichman set up Doctaly with the help of a GP friend, Dr Dinesh Silva, after finding he had to wait two weeks for a GP appointment.

Under the model, a senior partner at a practice holds a contract with Doctaly and then any GPs at that practice are free to register a profile on the company’s website and offer appointment slots when they are available.

Doctaly pays the practice a cumulative fee each month based on the number of consultations provided, and the practice then calculates how each GP should be remunerated – salaried GPs may have some of the fee deducted, for example to cover use of the room and reception staff.

Patients use the website to choose a doctor and book a 15-minute appointment slot, paying from £39.99 to £69.99 depending on the time and day of the week. The booking process requires the patient to confirm that they are not registered with the particular GP practice they choose.

Patients are also advised Doctaly does not provide emergency care, and that patients needing care for psychological problems or long-term condition management are better off going to their regular GP who understands their medical history.

After a Doctaly consultation, the GP provides the patient with a printed copy of the consultation notes and the patient is free to decide whether not not they wish to share the information with their NHS GP.

Readers' comments (67)

  • Dear anon practice manager,

    Before you reject the idea of an NHS, did you realise the GP share of the NHS budget is now 5.9%?

    I will only reject it once we are back up to 12% and patient demand has been tackled.

    Until then, don't fall for the grand plan of bleeding us dry so we feel we have no choice.

    We need to fight for our share of the cake and put pressure on the GPC to make this one of the conditions of a trade dispute.

    If we don't, then we are all losers.

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  • If I am a gp partner and want to offer private appointments, why would I use doctaly as the middle man? Wouldn't it make more sense for me to just offer private appointments and keep more of the profits for myself and my practice?

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  • My experience of working in private general practice is not good. Tends to attract hypochondriacs and self-limiting illnesses such as URTIs but because patient has paid expectations are very high and would expect to walk away with antibiotics. Anything that needs investigations even simple blood tests would end up needing referral to a specialist. Not many people prepared to pay for blood tests, radiology etc. when you could just refer to a specialist and these would then be covered by insurance. Also no safety net of follow-up appointment etc.

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  • i think it is an excellent idea, we should give choice to the patient, if they do not want to wait, this is the way forward, anything given free is never appreciated, all the consultation should be charged - at-least 5 pound/day.
    home visit should be charged too- we get loads of abuse.

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  • i think it is matter of choice, why should anyone should have a problem, NHS consultant has been doing private practice for so many years, if GP wants to do whats wrong in that??

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  • "GP's doing a few appointments on their admin day" Do they get paid by the NHS for their admin hours? IF so wouldn't this be fraud?

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  • Agree with 'GP partner' at 4.41pm.

    The patients will expect a diagnosis and script (which will be private, expect a fuss) in the consultation. They won't be expecting to pay for any investigations that are necessary. Sounds like more hassle than it's worth to me.

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  • @9.48
    I don't think you have quite grasped GPs' pay structure. Practices are paid a set fee to cover as much work as comes through the door (or telephones or emails or calls for a visit). The admin has to be done around the immediate clinical stuff - the working day just extends until work is finished, frequently 10-11 hours during the week +/- weekend catch-up work.You want us to be paid by the hour and be accountable to "management"? Can the NHS afford that?

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  • Now then, all getting their nickers in a twist!!
    Please get off your Nhs horse and face reality..

    The whole system is slowly being eroded and it is time we have few innovative companies try to take us out of this mess. There is no funding coming from the government, we will all have to pay for our health.
    What is wrong if I pay for my medical advice? Other day I had a chap look at my washer, upfront charge was 95 quid. My son works as a junior doctor and his hourly rate is 14.50 ! My gardner charges 15.00 an hour.

    We need to have a system where young doctors feel valued so that we attract more of them in the profession. Earning more for half your lifetime spent training is not a swear word. Bring it on, I say.......

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  • Dear All,
    I say again, we are here because of a sustained campaign by HMG to destroy universal easy access to NHS GPs. It is now working adn we are at a tipping point. Unless Mr Hunt comes up with shed loads of money (he won't because he doesn't intend to) then primary care NHS as we know it will disappear.
    This is a solution for patients and doctors problems arisen from desperation - if patients had access they wouldn't need it, if GPs had reasonable working conditions they wouldn't want it.
    Good luck to them.
    Paul C

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