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GPs go forth

Babylon's GP at Hand app signs up new patient 'every two minutes'

Exclusive The private company offering online GP appointments to Londoners via a host GP practice now has 26,000 NHS patients.

Babylon, the company behind the GP at Hand app - which promises a video consultation within two hours - said this comes as applications are coming in at a rate of 'one every two minutes'.

It also said patients were 'loving' the service, giving it a '95% approval rating'.

The news comes as local GP leaders from across the UK voted to demand an end to online providers who 'cherry pick' their patients at Friday's LMCs Conference.

Although the motion did not mention Babylon by name, many delegates used GP at Hand - which has stated an intention to roll out to other areas of England - as an example.

GP at Hand advises that its service may be 'less appropriate' for people who are pregnant or who have learning difficulties, drug dependancy, complex mental helath conditions, dementia or conditions related to frailty.

But a Babylon spokesperson said patients who have signed up to the service are 'across the ages from children, to people over 80, to people with complex health needs, as well as people in good health'.

The LMC motion said private companies who cherry pick patients 'undermine' general practice and said GPC should demand such services are blocked 'unless they are prepared to provide a comprehensive package for all patients'.

It also called for practices to be given extra funding for 'training, support and appropriate software and hardware' in order to establish online consultation services.

Dr Bethan Rees, a representative from Hertfordshire LMC, said GP at Hand 'takes funding away from general practice' and 'will undermine general practice as we know it’.

She said: 'What we need to ensure is that all GP services provide online consulting and not to allow fragmentation of our health service.

'The main problem with GP at Hand is that it allows cherry picking of patients which will financially undermine budgets of all of our general practices.'

But speaking against the motion, Dr Lynette Peterson from Oxfordshire LMC - who works for GP at Hand - said it shows general practice is a 'progressive, forward looking and forward-planning profession’.

Adding that she wanted to 'correct the misconception' around the claim 'that it’s all cherry picking', she said: 'Yes there are some that are easy patients, but it also attracts quirky, difficult, complex patients with multiple morbidities, with complex conditions who are trying to use multiple providers.'

Dr Peterson also argued GP at Hand deals with 'heartsink patients that the current NHS providers find difficult to deal with'.

She said: 'Telemedicine can play a role in providing care for these difficult patients that have previously taken up a lot of time within the NHS. I do however agree that we need to provide a comprehensive package for all patients.'

A Babylon spokesperson told Pulse: 'We've had more than 26,000 people sign up since we started, across the ages from children, to people over 80, to people with complex health needs, as well as people in good health.'

'We are getting one application every two minutes and patients are loving the service with the GP at Hand app receiving a 95% approval rating from users.'

Accusations of 'cherry picking' patients has riddled GP at Hand since the London launch, including from the BMALondonwide LMCs and the RCGP.

The GPC told Pulse at the end of January that it was considering 'all legal options' to challenge the rollout  of GP at Hand, following a vote of English LMCs in November.

NHS Hammersmith and Fulham CCG, which hosts Dr Jefferies and Partner, has launched a bid worth £250k to hire an ‘independent evaluator’ to assess the 'outcomes and impact' of GP at Hand.

Motion in full

AGENDA COMMITTEE MOTION TO BE PROPOSED BY HERTFORDSHIRE: That conference is concerned that new online GP services are targeting healthy, less complex patients, the funding for whom is partly used to subsidise care for more complex patients on the registered list and calls on GPC to:

(i) demand a stop to the undermining of general practice by private companies who cherry pick the patients to whom they offer services

(ii) demand that online consultation schemes do not become established unless they are prepared to provide a comprehensive package for all patients

(iii) support general practice to explore innovative ways of providing health care

(iv) demand the allocation of additional funds to NHS general practice to provide training, support and appropriate software and hardware in order to establish on line consultation services.

Motion carried in all parts.

Readers' comments (16)

  • Dear All,
    That's approx £3.3 million being sucked out of mainly local practices who will be left with those with real needs.
    Disruption is one description.
    Paul C

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  • Healthy Cynic

    I have absolutely no problem with such a service, which should offload trivia by the truckload from general practice. But it is not a replacement for GMS services and should not be funded as such.
    I'm interested to see how long it will be before a 'service user' is unable to access a GP core service from this provider. At that point the GMC need to be involved.

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  • All it proves is that the more access points we develop the more they will be used. it does not mean it is needed. All this causes is fragmentation of care and does not reduce demand for the normal practice . just because a service is used it does not mean it is appropriate use.

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  • Why not allow us to cherry pick patients as well? But that will never happen.
    Whats been allowed at Babylon is Simply not acceptable
    Lets have one rule for every one?
    Let them have same contract as ours and provide same services as ours. They can have extra money for providing telemedicine as LES and let patient choose where they want to go.

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  • Nhsfatcat

    Not a peep out of our CCG as to how we will HAVE to deal with these patients again when they need real help locally. I bet the answer will be you have to re-register then and provide care: anyone know the rules?

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  • Cobblers

    I really think NHSE and CCGs don't know how to deal with this. A new technology and without doubt cherry picking, leaving the complex multimorbidity to the carbon based GPs on the ground.

    AND they are not funded for it.

    Current funding is based on a mix of patients the low users subsidising the high users. Once there are less low users in the mix the funding for the high end is non viable.

    This is destabilising and it has come at precisely the time when GP is already underfunded and unstable.

    What is needed now, to make the point, is one of the practices in the middle of this maelstrom to go belly up.

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  • Cobblers

    Nhsfatcat I suspect the NHSE might use the TR rules to get you to sort out the mess for free.

    Isn't it lovely being an NHS GP?

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  • Dear All,
    I agree, we need a "remotely managed digitally enabled registration fee" added into the NHS budget as new money to support these services. To HMG its pocket money but it will enable the experiment and not harm the supposed jewel in the NHS's crown. Mr Hunt can conjure up the odd £500 Million every winter to bale out the local A/Es so the odd £10 million for the whole country shouldn't be a problem. Thats if he really cared.
    PauL C

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  • Perhaps we need to think about having regulations that say once you have registered with Babylon, you will not be allowed to return to your previous practice -- in other words, Babylon has to be prepared to provide all GMS services to all their patients or be held to be contravening their NHS contract.
    Now if they can service all their NHS patients in this way, then fine -- and the allegations of cherry-picking will go away. But if they can't, why are they being allowed to take on such patients?
    The real problem however will come when this scenario comes mandated by circumstances: when the original practices have had their more profitable patients removed, leaving them too few resources to cope with the less profitable remainder: then that original practice folds, and now there is no-one to look after the more complex patients.

    This is all highly predictable: we need the regulations amending to prevent cherry-picking as otherwise nemesis will inevitably follow.

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  • Vinci Ho

    I think one should mix the issues of the role of telemedicine and a cherry picking business together. I will have an open mind for the former but what actually had pis**d off people was the fact the latter was rewarded with the same remuneration as conventional general practice.
    I see no difference for private hospitals stealing ‘easier’ procedures from NHS hospitals with all kinds of exclusion criteria( the fixed tariff system).
    Another duplicity from this irresponsible government and its health secretary.

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