Controversy grows around GP at Hand service after minister’s endorsement

Health secretary Matt Hancock has been criticised for strongly endorsing GP at Hand, a new private company offering a remote consultation service via smartphones to NHS patients.

GP at Hand is part of a new breed of services offering patients tech-enabled consultations with primary care doctors and nurses, and is available on the NHS in some areas of London. The company behind the service, Babylon, and its founder Ali Parsa, says the service can lighten the burden on general practice, and provide convenient services for time-pressed patients.

Last week new health secretary Matt Hancock, a self-proclaimed advocate of digital technology, endorsed the service, saying it should be available across England.

Matt Hancock, Health and Social Care secretary speaking at the Babylon offices last week. Photo credit: Babylon Health

Mr Hancock made his comments last week at an event in London to unveil Babylon’s new $100 million investment in its AI capabilities in chronic disease management. The new funding will double its London team to more than 1,000 employees. The company says its technology can help make up for an acute shortage of doctors and nurses worldwide.

However GP at Hand has been dogged by controversy since its launch in November 2017, with many NHS organisations saying its ability to ‘cherry pick’ healthy patients is likely to destabilise bricks-and-mortar GP practices.

Speaking to The Telegraph newspaper last week, Mr Hancock said: “GP at Hand is revolutionary - it works brilliantly for so many patients and goes with the grain of how people access modern services.”

He added: “I want to see GP at Hand available to all, not based on their postcode. Where a new service challenges the system, the right response isn’t to reject the new service but to change the system. The current postcode lottery cannot continue.”

Dr Richard Vautrey, GP committee chair at doctors’ union the BMA said his organisation welcomed the minister’s support for IT, but said proper thought and planning was needed on the role of ‘smartphone consultations’.

“Providing online consultations is not as simple as picking up the phone and making a video call as you would to a friend or family member. There are issues of ethics, confidentiality and accountability that must seriously be considered before systems are put in place."

Addressing fears that a national roll-out of the service would destabilise an already under-strain general practice, Vautrey added: “We support innovation and development, but this cannot come at the cost of basic, face-to-face, holistic care for patients who rely on their GP the most. Patients don’t want their local GP practice replaced by a remote anonymous call centre.”

Mr Hancock’s comments also raises questions about whether he overstepped his authority – NHS England and local CCGs are in charge of commissioning decisions, not the secretary of state for Health and Social Care.

The minister’s remarks were directly criticised by Sarah Woollaston MP, the influential Conservative chair of the Health and Social Care committee.

She tweeted: “NHS England needs to hold firm and insist on proper evaluation of unintended consequences as well as benefits of services like GP at Hand before further roll out. Risk of further destabilising already fragile services.”

Nigel Edwards, chief executive of the Nuffield Trust health think tank also chimed in, calling for results from a formal evaluation of the service to be made public before further roll-out of the service.

While Mr Hancock has made his support for new digital innovation clear, his comments on the pharma industry have been much less warm - he recently claimed the sector was trying to "rip off" the taxpayer with over-priced medicines.

NHS England is expected to rule on a move by Hammersmith and Fulham CCG in London to block the roll-out of the GP at Hand service to Birmingham within the next few weeks.

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