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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)

  • I have been very naughty. I just did a HGV medical in my 'NHS' premises and I charged a private fee. And then I did an adoption medical and charged a private fee. And then I did a diving medical and charged a private fee. Will I be told off by the NHS police.....

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  • 1. Ideally there would be no private medicine it is queue jumping and it doesn't exist in Alberta Canada where I work for that reason. Doctors are paid better here of course and no beurocrasy.

    2. If youre going to do it this system seems a pain in the arse. The odd patient for 40 quid. surely youwould want at least 10 together to make it worth while or charge more.

    3. who cares about having all their notes for most things. As said for long term conditions might need it. Again here in Canada people go to random clinics a lot not just their own doc if they even have one and it works ok. This service is more for urtis m.skel, STIs, new symptoms and worried well and if not reassured may well be advised to keep the appointment with their own GP which was 2 weeks away. so what?

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  • Canadian GP.....keep up! there's a whole lot of stink going re introduction of private practice in Canada.see THEBMJ this week

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  • I am a full time NHS GP. I created Doctaly in an attempt to redress the balance. For too long there has been a total disconnect in what our monopolised NHS contracts offer us, for perceived versus actual activity. I have found that supply will never meet demand because it is free. GPs and more recently junior doctors have been the easiest targets for cost cutting despite repeated calls from the profession that funding is required. I know great doctors who have been totally demoralised and turned into faceless cogs worthy of culling at the drop of a hat. I want to bring value and appreciation of general practice and champion excelling GPs be that salaried or principals.
    Private care already exists so why can't the ones doing all the complex NHS work be the ones who benefit from what dissenters call "cherry picking". Hospitals have been doing this for years to balance their books whilst also being paid on activity. The same can be seen in dentistry.
    I fundamentally believe that by creating extra affordable appointments which are fair to the GP, pressures will invariably be taken away from NHS services creating a level of order. The patient who pays would have gone on to use an NHS services be that A&E or a GP appointment. Ultimately I hope to bring an appreciation of a GP appointment and in turn, force proper funding of primary care by bringing a little bit of power back to the GP.

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  • Private services are going to gain momentum and this is just the normal transformation and consequence of the collapse of NHs. If Doctally wishes to expand and take over or contract sites where these services can be provided, many would gladly join and ditch NHS. The questions remaining to be clarified would be your indemnity premiums which may spiral and eventually the premises costs - would one earn enough to mange those. Subletting consultation rooms to other GPs or Specialist Consultants and/or taking a percentage of payments made for each visit would need to be worked out to ensure liquidity of business. Most of the private clinics work that way.

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  • Dinesh, how does it affect your indemnity premiums and rent reimbursements if you see 2-4 private patients a day? Please give us an idea.

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  • Took Early Retirement

    Surely, the (TOory) government will love it? I mean, it is a market in action!

    I don't blame any GP for taking part given they way they have been treated for about, er, ten years now.

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  • Took Early Retirement

    Surely, the (Tory) government will love it? I mean, it is a market in action!

    I don't blame any GP for taking part given they way they have been treated for about, er, ten years now.

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  • Finally! An opportunity to take matters into our own hands rather than just watch as our profession is ground into the dust. I have done a lot of thinking about this, and am struggling to see it as anything other than a complete win/win. Every Doctaly patient is one less appointment for the NHS to pay for. The model as I understand it just sweats existing assets that belong to the practice. And as GP's, we get a chance to supplement our gradually declining income. I spoke to my insurance provider, stressing that I would potentially be seeing people without their notes, and they were relaxed - no different to a home visit for example. Difference in premium was negligible.

    Time for a quick chat with the partner methinks....

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  • Sanjeev, the work is classed in a similar vein to OOH in that we are not furnished with the notes. There are differences in all the defence unions in how they indemnify partners and salaried GPs. I am with the MPS and I am covered for a session of OOH as a partner. There is no change to anyone's indemnity for creating availability and if I were to see 4 extra patients a week as I do currently there is unlikely to be any change to my insurance. Once you start to see a significant volume of patients the insurance will change, but if I very crudely say indemnity costs as a principal are approx £1-1.5k/session (4 hrs20mins) would equate to maybe 800-1000 patients a year. The practice income generated for that extra "private" session clearly makes the increase in indemnity fees almost academic. In our GP FAQs we state that each doctor must ask their provider how the insurance changes according to the number of patients they see because unfortunately there is no uniform answer.

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