Union warns GP at Hand ‘will destabilise’ GP practices
[London, UK] Unite, the largest trade union in Britain and Ireland, is calling on the government to ‘immediately’ scrap the GP at Hand service.
In a letter signed by more than 130 health professionals, members of the union said GP at Hand ‘threatens the very survival of NHS general practice as we know it’, expressing concerns that the service, which has only gone live in London, could be expanded across the country.
Developed by Babylon Health, the app is run by the Hammersmith and Fulham Clinical Commissioning Group, along with NHS England.
Around 26,000 patients have signed up to use the new service since November 2017, most of them aged between 20 and 39.
Doctors are now warning that the service is threatening the continuity of care of patients:
“Practices have seen their list sizes fall for the first time in years due to those patients registering with GP at Hand. There is, no doubt, that GP at Hand will destabilise other practices, robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients.
“Losing registration fees for younger, fitter patients who join GP at Hand threatens the model of general practice relied on by so many patients.
“The scheme is hoovering up the younger, healthier patient and restricts access to those who are pregnant, frail, terminally ill or suffering from multiple health problems," the letter, addressed to Health and Social Care Secretary Jeremy Hunt, said.
Dr David Wrigley, Chair of Doctors in Unite, said the service was 'seriously eroding the vital personal relationship between GP and patient'.
A spokesperson for GP at Hand told BJ-HC that more than 40,000 people applied to join the service within seven months, adding in a statement:
“Babylon has a sub-contract with the GP at hand practice, which receives the same funding from the NHS as the vast majority of NHS practices do. Capitation funding (the so called “global sum”) varies from below £35 per 15-44 man registered with a practice to over £190 for each person over the age of 85 [according to this presentation].
“The reality is that patients and GPs are flocking to GP at hand because they recognise the potential that high quality, digital-first 24/7 NHS GP services bring. The 200 GPs who have already joined Babylon do so because they are treated with respect and not put under the levels of pressure all too common in other practices."
The representative said 95% of Babylon doctors surveyed said they could manage their workload 'well', pointing to a BMA study from 2016 that showed 84% of NHS GPs described workload pressures as 'unmanageable' or 'excessive':
“Both Londoners and GPs clearly like GP at hand, which as a free-at-point-of-need NHS service, extends 24/7 primary healthcare access to more members of the public.”