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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.