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​CCG’s £32m Babylon deficit ‘may lead to practice closures’, Hancock told

The CCG hosting Babylon GP at Hand is reportedly facing a £31.8m deficit due to financial pressures caused by tens of thousands of patients registering with the digital-first NHS GP service, Pulse has learned.

As of mid-March, over 47,000 patients were registered with GP at Hand, of which only 10% were from Hammersmith and Fulham, new figures have shown. 

The council’s health lead has warned in a letter to health secretary Matt Hancock that this could threaten Hammersmith and Fulham patients and ultimately ‘force practice closures’. 

However, public health and primary care minister Seema Kennedy said NHS England ‘does not believe’ the CCG has had to scale back services because of the ‘extra financial burden’. 

This comes after Labour MP for Hammersmith and Fulham Andrew Slaughter wrote to the Health and Social Care Committee, to ask for an inquiry to be carried out into the concerns with the GP at Hand app. 

In a series of letters sent to health and social care secretary Matt Hancock earlier this month, Hammersmith and Fulham’s cabinet member for health and social care, Councillor Ben Coleman, revealed the CCG is facing ‘an accumulated deficit in 2018/20 of £26m as a result of Babylon GP at Hand – £10.2m in 2018/19 and an estimated £16m in 2019/20 based on current growth’.

But a spokesperson for Hammersmith and Fulham CCG confirmed Pulse today that the 2019/20 in-year deficit attributable to Babylon GP at Hand is £21.6m, suggesting a total health funding deficit of £31.8m for 2018-20. 

Under the Government’s ‘choice’ scheme – that allows patients to join practices outside their area – the CCG has to pick up all the health costs of the patient, including any secondary care services.

Cllr Coleman told Pulse: ‘Matt Hancock is fully aware of this problem. He is registered with GP at Hand himself and he is doing nothing to address the fact that the service he is benefiting from is costing my borough’s residents £30m in lost funding for healthcare.

‘Whether it’s a good thing or a bad thing as a service, it’s iniquitous, wrong and immoral that the residents of Hammersmith and Fulham should be required to pay for people who don’t live in our borough to get the service.’

According to Hammersmith and Fulham CCG, Babylon GP at Hand has now 47,631 registered patients, of which only 4,555 are from Hammersmith and Fulham.

Cllr Coleman also called on Mr Hancock to reimburse the £10m costs of the service to the CCG and provide funding to meet the full deficit in 2020/21 and beyond.

He said: ‘GPs in H&F also tell me they are losing their healthier patients to Babylon, which reduces the income they have to treat patients with higher needs. This may eventually force GP closures and become a problem across the country.

‘It is simply unfair that a single CCG in a west London borough with high levels of child poverty should be required to meet these costs, and that health services for H&F residents should be threatened, just because Babylon GP at Hand is based in a GP practice in Fulham.’

Responding to his letter, Ms Kennedy said: ‘With respect to £10m overspend that the CCG has reported in 2018/19, NHS England would have to look at any overspend in more detail and at the CCG’s final annual accounts to better understand the precise finances and financial impact of any changes within the borough.

‘NHS England does not believe that Hammersmith and Fulham CCG has had to scale back services because of the extra financial burden of GP at Hand registrations.’

A Babylon spokesperson said: ‘We want to make it easier for patients to see a GP so this issue between Hammersmith and Fulham CCG and NHS England needs to be resolved, but in the meantime the needs of patients have to be put first. People have the right to choose their NHS GP practice and nearly 50,000 have chosen Babylon GP at Hand because they want to have fast and easy access to a GP.

Babylon is not taking money from other practices by having younger patients. There is a Carr-Hill formula that is the basis for how NHS GP clinics are funded. It weights payments by age and gender, as well as other factors, so that practices are paid depending on who registers with them. The amount varies from below £35 per 15-44 man, to over £190 for each person over the age of 85.’

NHS Hammersmith and Fulham CCG previously said it needed an extra £18m pot of funding from NHS England to cope with the number of patients. This led to neighbouring CCGs bailing out the CCG, with over £1m in funding.

At the same time, NHS England’s London regional team agreed to re-allocate funds from other London CCGs. However, some CCGs, including Tower Hamlets, Lambeth and Southark, have objected to covering the costs of patients residing within the CCG but signed up with GP at Hand.

Mr Hancock has also been criticised by GPs for appearing to promote the private company, even appearing in a Babylon-sponsored interview with the Evening Standard praising the provider.