Concerns over GP at Hand’s effect on local primary care in the NHS

https://www.theguardian.com/society/2019/may/30/concerns-over-gp-at-hands-effect-on-local-primary-care-in-the-nhs

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There is an important debate to be had about the use of digital technology in NHS services (NHS trust plans switch to ‘virtual’ emergency treatment, 24 May). Babylon GP at Hand has the potential to cause significant damage to local primary care provision – as we are seeing in Hammersmith and Fulham (H&F). Based in a single GP practice in Fulham, Babylon GP at Hand takes patients from anywhere across London (and further, with an agreement to extend to patients in Birmingham). It is now 10 times the size of the next largest practice in H&F, with more than 51,000 registered patients.

We have a number of key concerns. GP practices are funded according to the number of patients on their books. Loss of patients means loss of income. Money also comes to the local clinical commissioning group (CCG) for patients registered with the local GP practices. To date, H&F CCG has not been reimbursed for any of the patients registering with Babylon GP at Hand from outside north-west London. This has added £26.1m to a total deficit of £37m this year for the H&F CCG. As this is an in-year position, the deficit from Babylon GP at Hand, taking into account 2017/18 figures, is £35m. This is money lost to patients who live in H&F.

A just-published evaluation report of Babylon GP at Hand shows patients are overwhelmingly drawn from a younger, more affluent and usually healthier cohort. Other GP practices are potentially destabilised as they are left to care for older patients, those with more complex needs and those with continuing and home care needs, who cost the practice more. The report shows that more than a quarter of patients registered with Babylon GP at Hand deregister within two years – significantly more than deregistration from normal practices – bringing more instability to primary practice while increasing administration costs.

The unacceptable costs of Babylon GP at Hand should immediately be paid to H&F CCG whose budgets are being significantly undermined.

Digital access should be researched, developed and clinically evaluated centrally and then be available in all GP practices. Digital is too important to be allowed to expand under the auspices of private companies who appear to demonstrate a disregard for the consequences of their actions on the majority of frontline primary care teams.Merril Hammer Secretary, Hammersmith and Fulham Save Our NHS (H&FSON)Vivienne Lukey Chair, H&FSONAndy Slaughter MP Labour, HammersmithSteve Cowan Leader, Hammersmith and Fulham councilSue Fennimore Deputy leader, Hammersmith and Fulham councilCllr Ben Coleman Cabinet member, Health and Adult Social Care, H&FCllr Lucy Richardson Chair, health, inclusion and social care policy and accountability committee, H&FCllr Bora Kwon Inclusion and social care policy and accountability committee, H&FAnne Drinkell RGN, H&FSONJim Grealy H&FSON, Inclusion and social care policy and accountability committee, H&F