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Babylon expansion sparks ‘NHS destruction’ warnings

Necessary tech 'disruption' or cherrypicking?


Digital healthcare service provider Babylon is looking to consolidate its ever-growing presence in England's health service, but traditional general practice groups say the move could destabilise the NHS.

Babylon is one of several new tech-based firms offering virtual consultations for patients with doctors via their computer or mobile phone, but Babylon's expansion via its ‘GP at Hand’ service has generated the most controversy and opposition since it launched its service on the NHS in November 2017.

The company is accused of 'cherry picking' patients, so that it takes on only the time-poor, relatively healthy patients, and leaves the most complex cases to the existing GP providers. However the Department of Health, led by health secretary Matt Hancock, is enthusiastically embracing these digital service providers.

The NHS Long Term Plan states that from 2021 every patient in England should have the option to access online and video consultation.

The latest furore centres on Babylon's plans to take on the status of a primary care network (PCN) - a group of healthcare practices working together to offer a co-ordinated service for patients. These new groupings are at the forefront of the NHS Long Term Plan, with all GP practices in England expected to join PCNs by July this year.

Each network is expected to cover up to 50,000 patients in a similar geographical region, however the GP at Hand service has come under fire due to its registered patients (which has passed the 50,000 mark as of yesterday) living across a wide geographical area.

A spokesperson for Babylon told PMLiVE that while the planning is still in its early stages, they believe the service is “well-placed to be a primary care network” and has already formed “strong links with community providers”.

They added: “The NHS has called for Primary Care Networks to make it easier for patients to see a GP and for GP practices to be open for longer – this is exactly what Babylon GP at Hand does, patients can see a GP, often within 30 minutes, 24 hours a day, 7 days per week, every day of the year.

However GP groups, including the Londonwide local medical council (LMC) have said the development would be unfair to traditional PCNs that have signed the new GP contract.

The contract, which came into effect on 1 April, states that PCNs must exist within the same clinical commissioning group (CCG) area and not exceed 50,000 registered patients.

In return, PCNs are guaranteed around 20,000 additional healthcare staff, such as clinical pharmacists, physician associates, physiotherapists and paramedics by 2024, but how this will fairly benefit all the patients registered with GP at Hand is another question.

Dr Michelle Drage, chief executive of Londonwide LMC said the digital-first provider told Digital Health the service could “disrupt the system to the point of destruction” if it becomes a PCN, with the consequence of “further destabilising all current NHS service in London as GP, community and hospital funding moves to covering people in clearly defined geographical areas”.

She warned: “In accordance with the Network DES, negotiated nationally between the BMA's GPC and NHS England, commissioners have been clear to local GP practices that their networks must exist inside contiguous boundaries. We ask the CCG, NHS England and the health secretary - who is a registered patient and public advocate for Babylon GP at Hand - will all GP practices and networks be governed by the same rule book?”

A total of £1.8bn in funding is earmarked for PCNs, with standard-sized networks expected to receive around £180,000 by 2020 according to the BMA.

The Babylon spokesperson added: “The NHS wants practices to share information and technology, make it easier to get advice from health professionals, book appointments online, have remote testing and use online consultations. They want to ensure that whoever you see in your area, the health professional has access to your medical history so they can give the care you need.

“In short, Primary Care Networks are about improving care for patients, not restricting them, and Babylon GP at Hand does all of these things very well.”

16th May 2019


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