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Second private online GP provider looking to partner with NHS practices

Exclusive A second major provider of private online GP consultations is looking to offer its services via the NHS, Pulse has learned.

Push Doctor, which currently offers video GP consultations ‘in minutes’ at £20 each, told Pulse that it is seeking ways to provide NHS services.

Birmingham LMC chair Dr Robert Morley told Pulse that Push Doctor had ‘contacted all Birmingham practices’ in a search for partners who could use its technology.

The bid comes as fellow online provider Babylon Health is actively seeking to expand its NHS service offering elsewhere in the UK, having already signed up thousands of patients since its London launch in November.

Although Push Doctor stressed plans were in early stages, the company said it was seeking to work with multiple GP practices across multiple CCGs.

Founder and chief executive Eren Ozagir said: ‘As a category leader with unrivalled UK experience in delivering high quality regulated digital healthcare we continue to explore, with stakeholders at a local and national level, how we may work together to bring Push Doctor's unique levels of speed, availability and convenience to NHS patients and at the same time greater efficiencies in the provision of care.’

He said both the NHS and the CQC – which published a report on online providers last week – had ‘repeatedly stated the importance of digital in improving patient choice and the quality of care’.

But, despite this, Dr Morley said there was concern locally over what the plans will mean for GPs, adding: ‘It is a matter over which the LMC is liaising closely with the CCG and NHS England locally.’

At the same time, Babylon Health confirmed to Pulse that 'multiple talks’ are ‘going on with cities all over the UK’ about expanding the GP at Hand service beyond London.

GP at Hand has proved extremely popular, with 4,000 patients a month signing up since the November launch, but it has faced a backlash from GP leaders including the BMA, Londonwide LMCs and the RCGP.

Medical director Dr Mobasher Butt said: 'We're looking at sites all over the country. Obviously any of the major cities would be great locations.'

The comments come as board papers from NHS Hammersmith and Fulham CCG, where GP at Hand’s London host practice is based, had said Babylon Health planned to launch its NHS service elsewhere ‘in July 2018’.

GP leaders’ criticism has focused on current advice that the service model may not be suitable to certain patients, including those who are frail or pregnant, prompting allegations of ‘cherry picking’.

Although Babylon Health has refuted the claims, saying GP at Hand has patients from ‘across the ages from children, to people over 80, to people with complex health needs, NHS Hammersmith and Fulham CCG board papers said 'almost all of the new patients are in the 20-64 age group, with three-quarters under 35'.

Readers' comments (28)

  • Dear All,
    Good. The more offering their services to GPs the better. We need a market in these add on services with healthy competition. Lets hope NHSE understands this.
    Regards
    Paul C

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  • As I have said- the march of these services is irresistible. It's what people think they want and for quite a large swathe of consumers what they really really actually want. It is now unstoppable.
    The only problem for Babylon is whether they can marshall the resources to cope with the demand.
    And to repeat - prescribing privilege will fall, not now, not soon but eventually.

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  • Pandoras box is well and truly open but there is no hope in the bottom of this one.

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  • We need to acknowledge there is a gap in provision which leads to these kind of services being popular.

    Our patients needs to understand it may however have unintended consequences as the market forces will dictate i.e. fall of traditional free at point of delivery general practice.

    This is something I'm sure politicians are all very aware - and probably looking at it with smiles bigger than cheshire cat's, paving way for privatisation of NHS

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  • Second class medicine, advocated by a third rate government. Really on line consults are vastly inferior, superficial assessment at best, pandering to the worried well. God help the vulnerable, old and those with actual real pathology. That this is gaining traction is bad for General Practice and dangerous for patients,

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  • Vinci Ho

    If people/patients are willing to pay that £20 to ‘see a doctor’ , I would say ,’ whisper of words of wisdom , let it be.’
    For Babylon, CCGs just need to cut their tariff for each patient encounter . Let them ‘peanut picking ‘ , by all means .

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  • Excellent idea - market forces taking over and hopefully it will reduce reliance on NHSE selective budgeting of Practices. BMEs rejoice - parity nigh!

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  • Frankly I think its all over. This is a house of cards waiting to fall. I have the same feeling now as I did about the NHS pension scheme - I was one of the first to leave that. Time to leave before the rush and I am saddled with a bust business?

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  • Alberto

    fed up | GP Partner/Principal04 Apr 2018 12:12pm
    I’m completely with you. House of cards. We’re talking about the complete restructuring of primary care. More opportunities for private work ok, but don’t kid yourself this is designed with anything but consumerism in mind. It’s going to cost the country collectively a lot of money. Health care is expensive, this is only going to make it more so. Convenience costs. We can’t afford the current inconvenient service so we decided to opt for a more expensive convenient one instead. But convenient who for? The ill or the well? Seems to me making health care super easy for the worried well diverting resources from those who are actually ill is the wrong path to take. Who cares hey, I want it all, I want more and I want it now.

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  • Undoubtedly virtual healthcare is the way that things will go. It has happened with most other service deliveries models. It is expanding in the legal profession. Veterinary medicine is already moving this way. Amazon and it’s Chinese equivalent, Alibaba are causing complete disruption to standard retail shops. Having done it in my own practice for many years, despite what people say, it definitely leads to greater productivity, once both patients and clinicians get used to it. The problem that I found was that patients love the service and the result is the on line consultation rate goes through the roof. Fine if GPs were paid per consultation, but they are not. I wonder if Babylon and now Push Doctor are being given extra financial resources from NHSE?

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  • Tony 2:40 - nail on head. Like telephone consultations, makes it even easier for the "can't be too careful" consultation.
    But watch Ali Parsa on You Tube - he's set on replacing most doctor functions with an AI engine. And history is not on our side. Already (and for some years, actually) the ECG machine is better than the human at diagnosis. We are expensive. Bots are very cheap - almost nil marginal cost after development costs.
    Ever felt like a King Cnut?

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  • Anon2016 3.17pm

    This is my view on AI:

    AI will have more knowledge than all Polymath/Professor/Consultant/GP(s). It will also have ‘experience’ to pick the most appropriate investigation/treatment/surgery (performed by robots) for individual patients. Google’s AI, Deep Mind, has been gathering this information at the Royal Free, without patient consent, to understand why clinicians make the decisions that they do. It will be able to pick through the slightly abnormal scans, bloods and decide as to what is significant requiring further investigation. It will have all of our ‘experience’ and will be continuously developing its own experience, identifying where further research should be done. The only thing that is in question is to will AI will have developed enough for patients to have equal empathy with Bots compared to clinicians. If not there will be space for people picked (by AI) and further trained to be caring and empathic to deliver pleasantries and advice to patients. Much of the role of the GP is about reassurance and explanation. Rates of pay will be comparable to low level nursing, if even this high. All the knowledge and experience will come from AI. So no need for a medical degree or postgrad qualifications. The Govt will save a fortune. The other question is will Bots have developed enough to take over the role of the health care worker..toiletting, feeding, chatting to patients...?

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  • I can see a time when automated AI delivered healthcare along the grounds that I mentioned above will still remain free in the NHS. This will largely limit the rising costs of healthcare delivery for the Government. However any human contact, either virtually or face-to-face, will require a separate fee, much like Ryanair and other services.

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  • Alberto

    Well there’s absolutely no long term future in being a GP then. I guess we just need to be thankful we lived in a time when there was value in knowing stuff and possessing personal skills. We are moving to a time when people will all be indulged empty heads. I can’t see life will be much fun, there’s personal reward in understanding even if society as a whole comes to place no value on it. I’m not sure the future is going to be much fun...lots of work for mental health AI bots though that’s fairly certain. Plenty of empty depressed lives I suspect.

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  • Yup
    Watch Eric Tool on YT The great inversion of medicine.
    https://www.youtube.com/watch?v=y9nS1b7ifSE
    This talk is almost two years old, so you can see how his predictions are playing out before our eyes.

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  • Ex-GP 4.47pm

    Sadly I wish I could be more positive. The scenario that I present is not going to happen tomorrow and I cannot give a timeline as to how long it will take, but unfortunately the only long-term future I see for young GPs and many other Doctors that decide to remain in healthcare is to move into management and get as high as possible and put up with the politics. I know that for most of us this is not what we trained for or wanted to do, but there is a reason why doctors move into jobs in the BMA, Royal colleges, government advisory rolls etc. Mind you there will only be a limited number of jobs. Sorry to be so pessimistic.

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  • Tony - once you opt out of the NHS treadmill, there's a host of opportunity out there for medics who still practise but also dive into the commercial world. Still very possible to turn this to our advantage. "When pushed, pull... etc"

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  • anon2016 5.22pm

    Yup!

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  • anon2016

    I agree, but there are many doctors who are frightened of moving out of the illusionary safety of the NHS. It used to be safe and secure, but unfortunately like everything else in this changing world that is no longer the case.

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  • Frogs in hot water.
    And as much as I have never regretted leaving my partnership, I'm currently between jobs. Which is one reason to maintain a diversified portfolio of activities. Another is that that makes you more employable.

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  • Karen Morton

    I have to declare a conflict of interest here as I founded an online service which offers GP telephone and email consultations; and very importantly, access to gynaecologists by phone. My GP trainees have just changed over after 4 months with us. I barely had time to get to know them. They can barely have had time to touch the surface of O and G. How can they really provide good care in the community with such a short experience? I asked at the LFG 'Surely it should be extended back to 6 months?' but was told that women's health is not even compulsory. Is it small wonder that the most ridiculous referrals for next to nothing are made to the hospital and huge numbers of unnecessary scans are requested? This all costs a huge amount of money and wastes women's time and their employer's money. It almost certainly contributes to the Gender Pay Gap or as I call it, the Gender Career Progression Gap. Surely access to specialists remotely is the right thing, saving the face to face for when it's needed. It can be done safely and should be done.

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  • We’ve been told by our CCG that we have to engage in e-consult. My concerns are that is makes us available 24/7 and there is no extra money to deal with this extra demand which may reduce OOH/111 input. What about indemnity effect?

    Comments on AI - I think we may become supervisors/consultants with AI. Clinical examination can be invaluable and currently needs a clinician. I think e’re a generation away from any radical change here.

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  • Karen Morton 9.05pm

    I agree and would go further. All consultations should ideally be done by phone or Skype / Video link first in both General Practice and Hospital.

    Having been part of a referral management centre in the past, I also agree that many GP referrals appear to be inappropriate. However one has to look at the reasons for referral. Lacking the knowledge is NOT the main reason. Here are some other reasons:

    The patient wants a second opinion and sees the GP as a referral portal to real Doctors.
    The patient has multiple complicated symptoms that require a lot of time, something that GPs do not have. GPs are not paid directly for their time.
    Some GPs do not have access to certain scans...
    The patient has private health insurance
    Often GPs with the most knowledge refer more because they worry about rare conditions
    In the modern world of complaint culture many GPs worry about litigation. They too are inundated with what experienced GPs feel are inappropriate referrals from nurses, pharmacists, care homes. The threshold to consult has changed and we are all equally busy.
    It can be stressful blocking a referral that a GP knows is not required and can cause a breakdown in the Doctor / patient relationship. This can be less of an issue in secondary care where the respective patient may not be seen again.
    Being the last to hold the buck is not pleasant.

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  • Spot on Tony, combined with a decade of decreased funding in real terms and an end of days recruitment crisis to name but two of many negative issues affecting general practice.Any surprise we are in a death spiral.

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  • Karen Morton 9.05pm

    Another point: If your GP trainees spent most of their time doing Out Patient clinics while being supervised by seniors, rather than on the wards, they would have ample time to gather enough experience in four months. When I was in Canada, years ago, that was how GPs were trained.

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  • That's the problem with junior hospital posts, it is more about service rather than training - we would need more consultants for it to be truly consultant led and also more IT in hospitals. But the consultant job would be even more harder.

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  • could they stop sending them to A^E when they don't know what to do with them and the patient is registered but lives 100s of miles away. fed up of dealing with rashes that have been present for 4 weeks or more - not joking, sent to A^E by these companies rather than referred to a local GP service. patients are totally confused how to access services. mind you 111 is even worse.

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  • Alberto

    Theres lots of expertise and plenty of good ideas on how things should be organised that to me is clear, the problem I feel is an absence of sensible coordination at the macro level. This is primarily because macro level coordination is in the hands of politicians with little understanding of basic science. Their primary concern is short term popularity, and they rely on home spun ‘common sense’ and the ‘advice’ of politically appointed ‘experts’ who often have expertise in completely the wrong field (Lord Darzi being a perfect example). It’s a consequence of the fact the NHS is funded out of taxation and it’s difficult to argue against political control of how the money is spent. We need to find a way to prevent politicians using the NHS as a popularity and vanity tool. The biggest problem the NHS has is the vanity and ignorance of politicians.

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