Pulse summarises the big talking points in August – the extraordinary recent developments at the GPC and at the digital-first GP provider
What’s going on at the BMA’s GP Committee?
The election of Dr Katie Bramall-Stainer to the chair of the BMA’s GP Committee England by its members in August puts a very experienced hand on the tiller.
Dr Bramall-Stainer has been involved in the GPC since 2007, and all her experience will be needed as the committee faces huge challenges, internal and external.
The election for GPC chair, which saw her pitted against acting chair Dr Kieran Sharrock, wasn’t without controversy. It followed the ousting of the previous chair in circumstances that could hardly have been more contentious.
Dr Farah Jameel was elected as the first female GPCE chair in late 2021 but was suspended a year later amid complaints by staff. Dr Jameel began maternity leave at about the same time, meaning the complaints have never been formally dealt with. This ongoing lack of a resolution, at a crucial time for the profession, led to July’s motion of no confidence in Dr Jameel’s leadership, which was passed by the committee.
The motion did express sympathy for Dr Jameel’s situation but its proposers on GPCE stated that ‘ahead of significant impending contractual and political upheaval… proper, effective, democratic representation of the profession is of paramount importance’.
However, a backlash against the move saw a petition launched calling for the motion to be withdrawn. It cited Pulse’s coverage of the issue and attracted more than 800 signatures. The petition suggested Dr Jameel had been ‘unfairly treated on the basis of a number of protected characteristics’ [under the Equality Act 2010].
The BMA responded by insisting no legal obligations had been breached in the process. Pulse understands the GPCE chair position does not entail an employment contract with the BMA and so the Equality Act may not apply.
Nevertheless, the upshot is that GPCE – which has in the past faced accusations of a toxic, sexist culture – unseated its first-ever female chair while she was on maternity leave.
Dr Bramall-Stainer said the focus would now be on ‘the very survival of our profession’. She said she would be asking the Government for discussions on redistributing investment into the core GP contract, before setting out a ‘vision, strategy and plan’ later in the autumn.
Dr David Wrigley, Dr Julius Parker and Dr Samira Anane were all elected as deputy chairs by GPCE members.
Where did it all go wrong for Babylon?
Writing in Pulse, the Royal Society of Medicine’s senior GP Dr Jay Verma, who practises in London, said he was ‘hugely grateful to Babylon for leading the way and making digital access a reality’. Yet he also pointed to a ‘fundamental flaw’ in its business model.
The digital-first GP provider has confirmed plans to sell off its UK businesses. This could include its NHS arm GP at Hand, which serves 100,000 patients in London, although Babylon insists these services will not be affected.
GP at Hand became the first practice in England to register more than 100,000 patients on a single list in August 2022. However, its ‘unprofitable’ Birmingham operation was forced to close in November and Pulse revealed earlier this year that Babylon had indefinitely suspended out-of-area patient registrations for its London surgery.
So at a time when online access and triage has become widespread, what is the flaw Dr Verma believes has undermined the company? Increasing access for patients without properly understanding their needs.
After its launch, GP at Hand was accused by other GPs of ‘cherry-picking younger, healthier patients’, who fell mainly into the 20-44 age bracket. But it turned out that young age did not mean good health – nor low demand.
The mental health needs of younger patients was one aspect underestimated by Babylon, according to an insider. Dr Verma argues the company failed to understand patients’ motivations for contacting their practice and to have the right infrastructure in place to help them in the longer as well as the short term.
Last year Babylon CEO Dr Ali Parsa said the company lost money on every NHS patient, with accounts revealing GP at Hand was reliant on profits from the private side of the business.
Dr Verma puts this down to Babylon increasing its list size to boost profits but never looking at ‘smarter ways to provide treatment’. Its target audience, accustomed to ready consumption of digital services, used GP at Hand much more than anticipated.
Babylon says it is in ‘active discussions’ with potential partners to secure the continuity of its UK operation but has cut its catchment to anyone living or working within 40 miles of its surgery in Fulham, west London.
Has it learned what Dr Verma calls the ‘simple lesson’ – that to provide good care to patients, providers first need to understand them?
Just shows that the amount of money being offered to provide general medical services is insufficient. Even with the huge economies of scale that Babylon provides, there is still not a valid business model.
Politicians should take heed of this proof of understanding of primary care