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London CCG offering £250k to evaluate GP at Hand service

NHS Hammersmith and Fulham CCG has launched a bid worth £250k to hire an ‘independent evaluator’ to assess the ‘outcomes and impacts’ of Babylon’s GP at Hand service.

The CCG told Pulse that the procurement is still in the early stages so there is currently no profile of an ideal contract holder to evaluate the app via which offers patients ‘a video consultation with an NHS GP typically in under two hours of booking, anytime, anywhere’.

But the successful bidder, which will hold the contract for a year, will start on 1 June and be asked to evaluate the outcomes and risks presented by the service, including financial risks to the CCG, capacity issues and the effect on continuity of care.

draft approach to the evaluation has said it will provide ‘robust, independent, and rapid analysis of the outcomes and impacts of GP at Hand’ and look at how the practice is staffed, the impact on patients and the impact on the wider primary care workforce.

The evaluation will also undertake an ‘equalities impact assessment of GP at Hand’ to assess its implications for the wider Hammersmith and Fulham population.

NHS England had already asked GP at Hand to co-operate with an ongoing evaluation of the service, following a clinical review carried out in October.

The service, which recently launched across London has proved vastly popular with patients with 12,000 signing up in in just four months.

But it was met with scepticism from GP leaders, including the BMA, Londonwide LMCs and the RCGP, which accused GP at Hand of ‘cherry-picking’ young and healthy patients, as prospective patients were told the service may not be for them, if for example they were pregnant, frail or had mental health problems.

Responding to the news of the independent evaluation, a Londonwide LMCs spokesperson said: ‘Londonwide LMCs is not opposed to the use of technology.

‘But there is a need to test and prove the concept and reliability of that technology before scaling the offer up across London: particularly in light of the severely limited funds available to GPs to meet the needs of all patients who depend on their services in the capital. We hope the criteria and processes used in this evaluation address our concerns.’

NHS Hammersmith and Fulham CCG said the independent evaluation will ‘explore the wider system and policy implications of this practice model’.

A spokesperson said all types of organisations are invited’ to bid for the contract ‘to pull together an appropriate mix of expertise to undertake this work’.

A Babylon spokesperson said: ‘People using NHS GP at hand service can see an NHS GP 24/7 within two hours of booking, for free.

‘The improvements that this brings in safety, clinical effectiveness and convenience, compared to traditional general practice, are best highlighted through high quality research, and so we strongly support this independent evaluation.’

GP at Hand evaluation to date

The recommendations from NHS England’s clinical review of the GP at Hand service carried out in October found that the model ‘represents an innovative approach to general practice’.

It said that it had ‘the potential to deliver benefits to Londoners, as well as being closely aligned to emerging national priorities such as Online Consultation and NHS Online’.

However, it added that ‘as with any innovation, there are risks with implementation’, which need to be assessed

GP leaders were mainly concerned about patients being excluded from the service.

Although GP at Hand has said this is not the case, patients with certain conditions were advised the service may not be suitable for them, including those with frailty, dementia, pregnancy, drug addiction, learning disability and complex mental health problems, who may be advised to register elsewhere.

GP leaders said this was unfair to other practices receiving the same funding with Dr Robert Morley, Birmingham LMC executive secretary, saying it was ‘cynical exploitation’ of the GP Choice scheme.