Babylon’s NHS arm GP at Hand will pull out of Birmingham at the end of next month, with 5,000 patients told they need to register elsewhere.
The financially-challenged digital-first GP provider (see box) told Pulse its Birmingham operation is ‘no longer financially sustainable,’ with the virtual provision for the city, as well as its only physical clinic, set to close down on 30 November.
The company, which first expanded to Birmingham in 2019, said this comes as part of a strategy of ‘winding down’ unprofitable NHS contracts, however stressed it remains committed to its NHS GP offering in the UK.
A Babylon spokesperson said: ‘We will be closing our GP at Hand clinic in Birmingham this autumn, which serves approximately 5,000 patients in the West Birmingham and Solihull area.
‘As a priority, we will ensure the safe and smooth transition of all of our Birmingham patients to the care of other local GP practices.’
In addition to GP at Hand’s Birmingham exit, Babylon has recently also ended contracts with The Royal Wolverhampton Trust and University Hospitals Birmingham Foundation Trust.
The spokesperson said: ‘With the funding pressures the NHS is under, and the costs of capital rising, we’ve decided these partnerships are no longer financially sustainable as we focus on Babylon’s long-term financial viability.’
They added that these contracts and services collectively represent less than 1% of Babylon UK’s revenue – with the other 99% coming from its other GP at Hand NHS revenue and private contracts.
NHS Birmingham and Solihull ICB said it is ‘working closely’ with Babylon and NHS North West London ICB ‘to ensure the patients currently cared for by the GP at Hand clinic in Birmingham are able to receive the care they need in an alternative location convenient for them’.
The ICB spokesperson said GP at Hand’s patient list is spread out across Birmingham, adding: ‘All patients have been contacted to inform them of the closure and the need to register elsewhere, and we are providing additional support to patients to help find a suitable alternative to ensure they continue to have access to the services they need.’
NHS North West London ICB, which hosts Babylon’s NHS GP contract, said it is ‘supporting any patients affected by GP At Hand’s decision to close their Birmingham services to find alternative local provision as quickly as possible’.
Babylon said ‘GP At Hand services in London remain unchanged, with the company ‘fully committed to maintaining NHS GP at Hand service in the UK.’
However, the number of clinics in London has reduced from seven in 2020 to a current five locations.
The Babylon spokesperson said: ‘GP at Hand aims to put the most accessible, high quality, safe and effective NHS GP service into the hands of every person who chooses to register.
‘We remain committed to providing high-quality, accessible care to over 380,000 patients in the UK.
‘In the NHS, we serve over 115,000 patients and recent GP patient survey feedback shows that we’re delivering great services.’
In May this year, Babylon CEO Dr Ali Parsa said the company needs to be ‘super careful’ about expanding its UK GP services as it loses money on every patient.
Birmingham LMC chair Dr Gavin Ralston said: ‘Presumably those patients can return to their original practice but, as general practice is very busy at the moment, some will have to look at their list sizes and know they can cope with these additional patients and still provide a safe service.
‘I wouldn’t be surprised if there is a bigger concentration of GP at Hand patients around the clinic.
‘[The clinic closure] probably has less of an impact than a traditional general practice closing down.
‘It’s interesting that such a well-funded experiment of providing digital GP services – theoretically very suited to somewhere like Birmingham – hasn’t been successful. It suggests digital first is not what people want.
‘With changes that have taken place due to Covid, a lot of general practices have overtaken GP at Hand and offer the best of both worlds.
‘We were quite worried when they came in, because they were in a position to cherry pick younger patients who want easy access, leaving general practices with older patients who can’t use this kind of service. That was potentially destabilising for general practices in the city. The fact it hasn’t worked is a feather in the cap for general practice.’
BMA GPC England chair Dr Farah Jameel said: ‘Patients will be worried about what the closure of GP at Hand’s Birmingham clinic means for their health, and how this matter will be addressed.
‘At a time of immense pressure on general practice, any sudden influx of patients onto practice lists, if unmanaged and unplanned, will put even more strain on services. It will dramatically impact GPs’ ability to care for patients, and increase their workload as they tackle ongoing staff shortages and a growing backlog of care. It’s therefore essential that a local plan is in place to safely transfer patients back to practices, without overwhelming surgeries.
‘This situation isn’t fair to patients or to the GPs who look after them, and is exactly why the BMA questioned the viability of GP at Hand in the first place. The scheme was rushed out without proper evaluation, threatens place-based community care, and complicates local funding arrangements. Now, it is actively jeopardising patient safety by abandoning patients and simply expecting practices to pick up the extra work.
‘What we need is for general practice to be properly resourced, its estates to be invested in, its IT improved so that more surgeries can offer remote appointments to those who prefer it, and more GPs so that all of our patients can get the care they need, when they need it. This is the solution – not implementing schemes that dance around the real problems and which ultimately fail. There is a desperate need for responsible, ethical decisions on how public funds are spent. In the face of a dwindling workforce, Government and policymakers have a choice to invest in the right service the first time, and to focus every single clinician’s time and energy back into delivering safe and effective patient care.’
Babylon’s financial woes
Babylon Holdings Limited has been in financial difficulty for some time, incurring a loss last year of $374.5m, and of $188.0m in 2020, according to Companies House, with the full accounts for Babylon Healthcare Services Limited – the arm under which GP at Hand operates – acknowledging that it is ‘reliant on financial support’ from Babylon Holdings Limited.
The accounts say ‘there is no assurance that additional funds are available on acceptable terms’, and says that ‘there are material uncertainties (ability to fundraise further capital) related to events or conditions that may cast significant doubt on the group’s ability to continue as a going concern, and therefore to continue realising its assets and discharging its liabilities in the normal course of business.’
Babylon said that it required ‘significant cash’ ahead of last year’s listing on the US stock exchange.
Since 8 August, Babylon Holdings Limited’s shares have been selling for less than $1 on the New York Stock Exchange (NYSE), dropping from $0.98 on 8 August to $0.47 on 3 October – far short of the NYSE requirement that companies maintain an average closing share price of at least $1 over 30 consecutive days.
Babylon told Pulse it is ‘taking active steps and will continue to consider further opportunities to maximize value for shareholders.’
The spokesperson said: ‘Babylon’s focus will remain on delivering on its promise, maintaining its quality and moving closer to profitability.
‘Babylon will continue collaborating with our NHS partners to redefine how primary care is delivered in the UK. We look forward to providing exceptional service and setting new standards in our patient’s healthcare experience.’