Exclusive Patients registering at the new GP at Hand expansion in Birmingham will be on the Babylon primary care network patient list in London, the CCG hosting the digital service has confirmed.
NHS Hammersmith and Fulham CCG has confirmed that new patients registering with GP at Hand in the Midlands will be registered with the Babylon network, which just comprises GP at Hand patients and will be based in west London.
GP local leaders said the news ‘makes a mockery’ of PCNs, which are meant to be regionally based.
NHS England said that these were ‘temporary’ arrangements.
It follows the recent evaluation of GP at Hand, which warned that Babylon’s model ‘presents a challenge for a system of primary care networks if they are defined geographically’.
The digital-first service launched in Birmingham this week, after NHS Hammersmith and Fulham CCG gave it the green light to recruit patients in Birmingham and Solihull. However, commissioners set a limit of 2,600 patients to be registered in the area in the first three months.
Babylon had applied to be a standalone primary care network, but the CCG challenged the application, pointing out that the networks had to be based on a geographical region.
However, the CCG later relented and – although the networks have not yet been fully approved – it indicated that it would be approving Babylon’s application.
A spokesperson confirmed to Pulse that the new patients will be registered with this network.
A spokesperson from Babylon said: ‘Primary care networks should be about having joined up care for patients so that it’s easier for them to see a healthcare professional and get access to the right services, whilst reducing the burden on NHS resources – we do that by offering all the traditional GP services plus 24/7 access to a GP through digital consultations, often within 30 minutes, at no extra cost to the NHS.
‘Babylon GP at Hand patients will even be able to have physical appointments in other cities with GP at Hand clinics, because our system is so joined up.’
However, Tower Hamlets LMC chair Dr Jackie Applebee said: ‘I think it makes a mockery of the PCN initiative. PCNs are supposed to be geographically contiguous. How is Birmingham in any way, shape, or form geographically contiguous with London?
‘It also begs the question as to whether the Government – who ultimately allow this as Matt Hancock is a big fan of GP at Hand – really care about the integration of care. They talk the talk but how can a GP in Hammersmith work in an integrated way with services in Tower Hamlets, let alone in Birmingham? The whole thing is just another way to allow the private sector to let rip in the NHS.’
Londonwide LMC chief executive Dr Michelle Drage said: ‘We are disappointed that despite their offers to discuss the suitability of this PCN application and seek a resolution, the CCG have taken the path of least resistance by rubber-stamping it. It has been clear for some time that the intention of the CCG and STP was to approve the Babylon GP at Hand PCN application.
‘The additional decision to vary the contract to register patients from Birmingham and Solihull at a practice in Hammersmith and Fulham is equally worrying.
‘This decision is not good for patients or practices. It encourages fragmentation of services and rides roughshod over the ethos and detail of the NHS long-term plan, which highlights the value of place-based care.’
Dr Drage added: ‘We are particularly mindful that Hammersmith and Fulham practices who have submitted PCN applications which meet the contract specifications, should not lose out financially from any delay to this single application, which is clearly out of spec. Not only is this a nationally negotiated contract, but the provider in questions has national ambitions, so GP practices across the country will be watching closely. As the national negotiators for this contract, we will give GPC England our full support as they escalate the issues we have raised.’
Birmingham and Solihull LMC medical secretary Dr Robert Morley said: ‘It defies all the rules that practices and PCNs are under. I can’t see how it’s in anybody’s interest apart from Babylon’s. One has to question this power of resources it seems to have.’
An NHS England spokesperson said:’Each GP practice can be a member of only one primary care network. Arrangements for this practice are temporary pending the outcome of the review of out of area rules, announced in the new GP contact, which will be launched shortly.’