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GP practices outsource telephone consultations to private provider

Exclusive GP practices in Essex have cut waiting times by a third by subcontracting telephone consultations to a private healthcare provider, Pulse has learned.

According to one practice, the move has led to reduced waiting times for GP appointments within the surgery from three to two weeks over the past year.

Under the scheme, patients are offered the choice of booking a telephone or video appointment with a GP from the private health service Babylon or waiting for one of practice's GPs.

It is currently only available at two GP practices in the Southend-on-Sea area but provider company Babylon said it 'is soon to expand to many more'.

The two practices – the Highlands Surgery and Eastwood Group Practice – set up the scheme two years ago using transition funding they were granted for switching from PMS to GMS contracts.

The service allows patients registered at the practices to get the Babylon appointments free by using a promotional code when they book the appointment.

Dr Paul Husselbee, a GP partner at the Highlands Practice, said the move had freed up more consultations for patients with more complex conditions.

He said: 'We have noticed that waiting time for the routine appointments has reduced from about three weeks to two weeks. Babylon is giving extra capacity and is available 12 hours per day seven days per week. We would not be able to cover this many hours.’

Dr Husselbee added that the service 'is available to patients quickly to deal with more urgent problems such as coughs and colds’ and this ‘frees up surgery time to deal with the more chronic long-term condition patients who have regular follow up’.

Although Babylon GPs cannot access medical records in full, consultation notes are shared with the patient's practice within 24 hours so it can rule out concerns.

Babylon told Pulse that a recent evaluation at one surgery showed 18% of patients chose to have an appointment with a Babylon GP, and 80% of these consultations were closed without the patient needing further medical attention.

GP leaders had a varied reaction to the news, with Sefton GP Andrew Mimnagh, a former LMC chair, saying it sounded 'like a ‘pragmatic solution’ that ‘falls in line with the strategy on access' in NHS's own five-year plan.

But GPC deputy chair Dr Richard Vautrey cautioned that as the private GPs cannot access full medical records, other GP practices had to ensure they were fully indemnified before setting up similar schemes.

He said: 'Practices should be very careful if they are subcontracting the delivery of essential services to a provider that does not have full access to the patients clinical record and should be discussing this with their medical defence organisation.’

MDOs confirmed to Pulse there could be risks.

Medical Protection Society medicolegal advisor Dr Pallavi Bradshaw said: 'Where these consultations are being undertaken by doctors outside of the practice, issues of confidentiality and access to medical records can pose risks, as can lack of familiarity of the patient's history.'

But she added that 'there are advantages to remote consultations with greater access to care and reduced waiting times'.

Babylon medical director Dr Mobasher Butt said the service provided 'does not affect the indemnity cover of the GPs at the practice' because it is the patients' choice to book a Babylon appointment rather than a referral from the practice and therefore indemnity lies with the Babylon GP. He added that Babylon 'works closely' with the leading medical indemnity providers 'who fully understand our service and clinical governance' and insure all of the doctors.

Resonding to the comments about the lack of access to medical records, Dr Butt said: 'Babylon believes in open and transparent medical records. All patient consultation notes are recorded electronically, are available for any subsequent consultation with babylon,  and can be accessed at any time by our patients. Patients can also consent to share their babylon records with their NHS GP for joined up care.'

According to Dr Butt, the company is 'currently working with the HSCIC to fully integrate with NHS GP software providers which will empower patient’s to share their NHS data with Babylon'.

He said: 'Additionally, our doctors are fully trained to extract a patient’s full medical history during consultations and this practice is regularly audited.'

Commenting on the plans to expand the service to further GP practices, Dr Butt said: 'We are in conversation with a number of innovative practice across the country, who want to provide more tailored solutions for their patients and see digital as a way of doing so.'

GPs under pressure to adopt video and telephone consultations

GPs have expressed doubts about the potential for video or telephone appointments to manage demand and a recent study found very few have plans to introduce online or telephone consultations in the near future.

But the Government is keen to promote use of telephone and online video consultations – using software like Skype or Facetime – as part of its drive to increase GP access across seven days a week.

The GP Access Fund - formerly known as the Challenge Fund - has heavily promoted use of the technology as well extending telephone appointments.

Readers' comments (14)

  • Skype and telephone consultations are a great idea. Here is the but: GPs are, and should be, over-qualified for such consultations. And by the way, they offer £55/hour, LMFAO

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  • "Babylon and Dr Husselbee said that under their model, indemnity was not a concern." - Why and how?

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  • Dear All,
    Looks like the practices and Babylon have overlooked a major problem here. If a practice's patients are being treated by Babylon under a subcontract then it is an absolute that the practice gets a record of what has happened to their patients. The fact that Babylon are remote makes no difference, it is exactly the same as their practice nurse treating their patients in their surgery, who would allow your practice nurse to not make a record of what they did. Unless the article has it wrong this needs correcting urgently.
    Dr Paul Cundy
    Chair GPC IT Committee

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  • Paul Cundy | GP Partner 13 Jul 2016 12:21pm

    Please note above:

    Although Babylon GPs cannot access medical records in full, consultation notes are shared with the patient's practice within 24 hours so it can rule out concerns.

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  • I wonder how many of you are struggling with the 'NEW NHS.Net'
    You can guarantee that if there is anything that can be mucked up, DoH/NHSE will surely do an excellent job of it.
    For a few days now, I don't have access to the new because it won't accept my password. Yesterday, I had to call the helpdesk and was able to log in for an hour before the day ended. Today it's the same story and I was told to contact IT in Kent.
    IT support in Kent informed me that I need to change my browser to Chrome as IE is not supported. The polite gentleman suddenly then stopped 'hearing' and disconnected.
    Nice way to do a job DoH. Couldn't they have made sure that the whole of NHS was moved to Chrome before unleashing this upsetting novelty?
    Do I move to Chrome? No, as I have no guarantee that this will not muck up my laptop and VPN connection at home. The last time I had a problem it took IT in Medway one year to fix the problem and I had to sit at work on weekends to catch up with paperwork as couldn't work from home.
    BTW, the last call I logged seeking assistance was on 22nd of June 2016. Till date nobody has got in touch. Welcome to Medway.
    Hope the NHS bosses consider all aspects before launching new ideas and refrain from fiddling with or replacing systems that are functioning normally. There was no problem with the old but now we have serious issues as one can't communicate with colleagues re medical matters and no referrals or communication is possible through Outlook. Just shows how dangerous it can be to have that high level of reliance on IT and email communication. Most of the service like retinal screening, community nurses, respiratory team and diabetic nurses do not accept referrals sent in any other form! Smy referrals are piling up on my desktop till hopefully within the next 6 months NHS in Medway will intervene with local IT

    One thing is certain - again my conspiracy theory - someone must have made a fast buck on this transition else who would trash a working system to put in crap.

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  • Amazing , spend MORE money on the service and MORE patients get seen.
    Seems if sufficient money had been pain in over the past years this would not be needed.

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  • Although it's cool we're trying something new, in the end it's all pointless as there aren't enough doctors. If all practices in the UK were to do this it would overwhelm Babylon and where would the doctors manning the phones at Babylon come from?

    I'm sure Babylon is making a good profit on all of this though.

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  • Sounds like a significant pay cut for a few quick phone calls.
    Also will only continue to fuel demand.

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  • sensible use of transition funding, but, what happens when that runs out?

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  • Sticking plaster as usual

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