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NHS wants independent evaluation of GP at Hand service

The NHS is looking for an organisation to undertake an independent review of the on-demand virtual GP app, allowing patients in London to access GP services using their smartphones

NHS England has gone out to tender for an organisation to undertake an independent review of the GP at Hand smartphone app, after it has faced criticism from GPs.  

The app by Babylon Health, launched in 2017, allows patients across London to register with the on-demand service, giving them access to a GP 24/7 through virtual consultations.

The service is run by NHS Hammersmith and Fulham Clinical Commissioning Group (CCG), together with NHS England, with the contract being held by a GP practice in Hammersmith and Fulham.

However, the app, which is both commissioned and funded by the NHS, has been subject to criticism by the Local Medical Committees, which led to a clinical review by the CCG and NHS England at the end of last year.

The review, although overwhelmingly positive, found that the service has not been formally evaluated and that in itself could have “unintended consequences”. 

NHS England and the CCG now want an independent evaluation of the app, which it says offers a “digital-first primary care”.

“The app enables patients to access GP services 24/7, at short notice, via a virtual appointment using video conferencing and voice calls on a smartphone. Patients can also access symptom-checker services (driven by Babylon's Artificial Intelligence tool) and health monitoring software”, the tender document said

All types of organisations are encouraged to bid for the review, “including lead bidders and consortiums that are able and qualified to deliver a service such as this, which is hoped will pull together an appropriate mix of expertise to undertake the evaluation”.

Several London-based GP practices have been unhappy with the app, claiming it tricks patients into de-registering from their local practice. Some practices have sent text messages to their patients discouraging them from registering with the on-demand service, saying it “destabilises traditional GP surgeries”.

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One London practice told patients by text message, seen by Computer Weekly, that they have noticed “some patients are registering with the heavily advertised ‘GP at Hand’ service for video consultations without realising that this deregisters them from their local surgery”.

The text message goes on to say: “If you want a local GP surgery that can give you face-to-face appointments then you should not register with GP at Hand.”

However, according to NHS England, patients can access face-to-face appointments in one of GP at Hand’s six London-based sites.

“The service takes advantage of the National GP Choice policy to allow patients from across London to register with the service, with plans to expand the service nationwide,” NHS England’s tender document said.

“There are some limitations put on registrations from people with more complex care needs, who might need greater continuity of care, and more face-to-face support – with NHS England’s clinical review recommending that those individuals seek advice before registering .”

Between 1 November and 1 February this year, more than 14,000 new patients have registered with the service. However, it does exclude certain people from registering. According to their website, this includes pregnant women, elderly people, people with learning difficulties, drug dependence or those living with “complex mental health conditions”.

This app is separate to the NHS app, announced by health secretary Jeremy Hunt last year, which will give patients access to NHS services on their smartphones by the end of 2018.

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