CCG objects to extended roll-out of GP at Hand in Birmingham

Hammersmith and Fulham Clinical Commissioning Group (CGG) has recommended that it raises an objection to the roll-out of GP at Hand across Birmingham.

The CCG’s Primary Care Commissioning Committee was asked on 17 July to approve for the Babylon-powered service to be introduced at Badger House in Birmingham, which adds to the five London locations where it is live.

A roll-out of the GP at Hand service, which provides online consultations for NHS patients, has already been scaled back after NHS England lodged a formal objection.

The CCG has also commissioned a review into the impact of the service.

The latest board papers state that “further information is required to provide assurance on the safety of patients” before the extended roll-out can be approved.

The papers add: “In assessing the application against the criteria set out, there is evidence of concern regarding the risk to patient safety of implementing the proposal without further assurance being undertaken or received.”

In a letter, Paul Jennings, Birmingham & Solihull CCG, said he wanted to “formally object” to the roll-out on the “grounds of clinical safety”.

Jennings also asked for Hammersmith and Fulham CCG to refuse the roll-out until the independent evaluation is carried out.

A GP at Hand spokesman said the company was “surprised” and “disappointed” by the board papers, and said it had provided “detailed assurances about the clinical safety” of its service.

A statement from the company can be read in full below.

It has also been reported this month that the new secretary of state for health and social care, Matt Hancock, is signed up with Babylon.

Hancock is quoted in the Daily Mail as saying his “GP is through the NHS on Babylon Health”, and called the service “brilliant”.

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Statement from GP at Hand

“We are surprised and disappointed by the paper to the Hammersmith and Fulham CCG committee, having provided detailed assurances about the clinical safety of our service – including its expansion to Birmingham. The GP at hand service has already been subjected to more scrutiny than any other practice. For example, there is an ongoing NHS Clinical Review of the GP at hand service led by senior NHS England doctors, which continues to provide assurance about the service. With immediate 24/7 access to GPs, fully-recorded consultations and high levels of staff motivation and engagement, safety levels far higher than traditional general practice are able to be delivered.

“The paper contains several factual inaccuracies, which we will of course be writing to the CCG to correct, as well as providing explicit confirmation on the points raised in the paper. Most concerningly, the lack of a commissioning “assurance framework” is cited as a major reason for not approving the expansion. Your readers, and the public at large, will want to know why commissioners have been so slow to put such a framework in place, given GP at hand’s intention to expand has been widely known and reported for more than six months. People may speculate as to whether this is down to a lack of preparation, or the vested interests of a few seeking to block the expansion of GP at hand for their own financial benefit or ideological views.

“People have the right under the NHS Constitution to choose their NHS practice. GP at hand is an NHS service; paid for by the NHS; providing NHS services to all patients – just like the vast majority of GP practices throughout the UK. In less than a year, over 30,000 people living or working in central London have joined NHS GP at hand, with more than 4 out of 5 people rating our digital appointments giving them the full five stars. The average waiting time for an NHS GP appointment with GP at hand is 38-minutes, compared to waits for routine appointments in traditional practices of a week or more. And, of course, by providing care 24/7 – despite only being paid for the core hours of 8am-6.30pm Monday-Friday- GP at hand is supporting the rest of the NHS as well as maintaining continuity of primary care within a single provider no matter what time of day or night.

“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. 95% of Babylon doctors surveyed say “Usually, I can manage the amount of my work well.”. In comparison, the BMA showed in 2016 that 84% of GPs across the NHS reported that workload pressures are either “unmanageable” or “excessive” and having a direct impact on the quality and safety of the care they deliver to patients

“It is high time that the financial and ideological interests of the few are challenged, and the rights of the public to choose their NHS GP are respected.”

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