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CCG needs £18m in extra funding to cope with GP at Hand patient influx

The CCG hosting GP at Hand has said it will need an extra £18m in funding from NHS England this year in order to cope with patient numbers.

NHS Hammersmith and Fulham CCG asked for an in-year injection of funds in March, after calculating the extra cost of hosting GP at Hand – which is run by Babylon and allows NHS patients the chance to speak to a GP online within 48 hours – would be £10.6m in 2018/19.

The new higher figure was unveiled in board papers published by today, and comes as NHS England is still deciding whether to top up the CCG’s funding allocation.

Dr Jefferies and Partner – the GP practice which hosts the GP at Hand app for NHS patients across London – has over 26,000 patients currently. Before the launch of the app, the practice based in Fulham had just 4,000 patients.

Board papers said NHS Hammersmith and Fulham CCG was hoping to end 2018/19 with a small surplus.

But they added: ‘The plan requires £18m of external support from [NHS England] to cover the GP at Hand accelerated costs.’

And the CCG said that the extra funding is ‘expected but not confirmed at this point’.

The papers quoted CCG managing director Janet Cree as saying that ‘progress is being made’ on the discussions about extra funding.

She said there was ‘likely to be an agreement with NHS England on some financial support to the CCG within this financial year’.

It comes as GP at Hand recently told Pulse that 40,000 patients have applied to join the service.

And Pulse revealed earlier this year that a new patient signs up with the service ‘every two minutes’, amounting to 4,000 new patients a month.

A GP at Hand spokesperson said: ‘GP at Hand reduces pressure on other NHS services and budgets. This is achieved by making NHS GP appointments available 24/7, typically within two hours of booking, even though funding through the GMS contract covers only Monday to Friday core hours.

‘The reality is that people across London are exercising their rights to choose their NHS general practice. In less than six months, over 40,000 people have chosen GP at Hand, whose registered list is based in Fulham.

‘This, of course, means that [NHS] Hammersmith and Fulham CCG’s budget will need to increase as they commission services on behalf of more people. Balancing this, CCGs with fewer registered patients going forward will also see changes in their budgets.’

The CCG papers further updated the board on the progress of plans for a full evaluation of the rollout of GP at Hand. 

CCG leaders said they met with NHS England ‘to consider the bids to undertake the independent evaluation of the GP at Hand service’, with a successful bidder to be announced shortly.

NHS Hammersmith and Fulham CCG launched a bid in March worth £250k to hire an ‘independent evaluator’ to assess the ‘outcomes and impacts’.

Accusations of ‘cherry picking’ patients has riddled GP at Hand since the London launch, including from the BMA, LMCs and the RCGP.

Most recently, Doctors in Unite warned health secretary Jeremy Hunt that the model ‘threatens the model of general practice’ by ‘hoovering up’ younger, fitter patients.

GP at Hand has denied turning away certain patients, but its website says that patients with frailty, dementia, pregnancy, drug addiction, learning disability and complex mental health problems may be advised to register with a practice closer to home.

March CCG papers said ‘almost all of the new patients are in the 20-64 age group, with three-quarters under 35’.

Babylon, the company behind the app, has hit back at criticism by saying patients ‘have the right to choose their NHS practice’.