This site is intended for health professionals only

Cap on Babylon patient numbers in Birmingham set to be removed

Babylon will remove the cap on the number of patients that can register with GP at Hand if it succeeds in meeting a series of criteria, it has been revealed.

In June, Hammersmith and Fulham CCG announced that the digital-first service had been given the green light to expand to Birmingham, with a limited 2,600 list size alongside restrictions including a catchment area limited to the boundaries of Birmingham and Solihull areas. 

In board papers released today, the CCG revealed that the cap on the patient list size could be lifted on the condition that it has ‘fully implemented’ measures relating to screening by 15 September.

The committee also said it has no plan to enlarge GP at Hand ‘catchment area beyond Birmingham and Solihull local council areas at this time’. 

Babylon applied to launch a physical branch of its online services in Birmingham last year, but the plans were rejected by NHS Hammersmith and Fulham CCG – which referred the decision to NHS England – due to patient safety concerns relating to local infrastructure.

This came after NHS Birmingham and Solihull CCG wrote a letter to the London CCG, formally objecting to the move on the grounds of ‘clinical safety’.

But the digital company confirmed in February that NHS England decided to lift its previous block. 

GP leaders called the move ‘wholly inappropriate’ as the independent evaluation of the service, published in May, was yet to be published at the time. 

The CCG then required certain restrictions to be placed on service, including:  

  • a geographical area for patient registration to be limited to the boundaries of Birmingham and Solihull local authorities
  • a restriction of the number of registered patients to a maximum of 2,600
  • a robust automated solution covering screening to be established within three months
  • an assurance gateway to be undertaken eight weeks after commencement to assess whether the restrictions on geography and the list size limit could be withdrawn

According to the CCG’s latest board meeting papers, NHS England ‘could not be assured regarding access to screening programmes until the Primary Care Services England system had been updated to use the Birmingham ODS code’.

However, it said if a solution is found to this problem to enable the screening of patients in the Birmingham practice by mid September, then Babylon can freely register patients in the Birmingham/Solihull region. 

The papers state: ‘The Assurance Group recommended that, provided the Primary Care Support England (PCSE) system had been configured to use the Birmingham ODS code, the cap on the number of patients registered from the Birmingham and Solihull local authority area could be removed from 15 September 2019. This is in light of the impact on screening call/recall of patients if the Birmingham ODS code is not operational

‘Should the ODS solution not be in place for the 15th September then the cap on list size will remain at 2,600 until the solution is implemented.’

They added: ‘The feedback from NHSE Screening was that, although through joint working by members of the group good progress had been made, they could not be assured regarding access to screening programmes until the PCSE system had been updated to use the Birmingham ODS code. The practice informed the Assurance Group on the 12th August that they were not seeking to enlarge the catchment area beyond Birmingham and Solihull local authorities areas at this time.’

Babylon managing director of NHS services Paul Bate said: ‘Today’s decision means that everyone from Birmingham to Solihull who wants to join Babylon’s 24/7 NHS digital-first practice can now do so, getting access to high quality healthcare in a way that works round their busy lives.

‘We also welcome the addition of the new ODS code, which will help embed Babylon GP at Hand within the local system and pathways and are pleased that PCSE and commissioners are working to ensure it will be available in the very near future.’

Earlier this year, NHS England announced plans to make it easier for digital providers to set up practices in deprived areas from April 2020. 

In response, the BMA said out-of-area regulations should be scrapped as they are ‘not in line’ with wider NHS England policy.