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GP at Hand service will destabilise GP practices, says Unite

Union calls on government to scrap on-demand GP app, saying it threatens the future of NHS GP practices and is eroding the personal relationship between patients and clinicians

Members of the Unite union have written to health secretary Jeremy Hunt calling for the government to immediately scrap the GP at Hand service, saying it “threatens the very survival of NHS general practice as we know it”.

The app, by Babylon Health, was launched in 2017 and 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 funded by the NHS and run by NHS Hammersmith and Fulham Clinical Commissioning Group (CCG), together with NHS England. The contract is held by a specific GP practice in Hammersmith and Fulham.

So far, about 26,000 patients have registered with the service – but it does exclude certain people from registering. According to Babylon Health’s website, this includes pregnant women, elderly people, people with learning difficulties, drug dependence or those living with “complex mental health conditions”.

Members of Doctors in Unite said the online service has led to GP practices seeing a reduction in patient numbers.

“There is no doubt that GP at Hand will destabilise other practices, robbing them of the vital risk-pooling and cross-subsidy that enables them to provide good care to their more complex and unwell patients,” the union said in its letter.
“The scheme is hoovering up younger, healthier patients and restricts access for those who are pregnant, frail, terminally ill or suffering from multiple health problems. 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 union pointed out that people who are generally well make up about 70% of patients.

“Their funding helps surgeries care for the 30% who are sick,” it wrote. “It’s a system that works, because it’s fair. We all eventually end up in the 30%.”

Read more about NHS apps

  • NHS roadmap for digital services sets out plans for launching a joined-up NHS app, piloting its citizen ID platform and moving across to the new NHS.uk website. 
  • NHS Digital and NHS England have further opened up the newly updated NHS Apps Library, and are asking developers to submit their apps for assessment. 
  • Leicestershire Partnership NHS Trust’s informatics service has developed an app to help reduce the stigma around electro-convulsive therapy. 

Unite is not the first to criticise the on-demand GP service. Last year, criticism by local medical committees led to a clinical review of the service by the CCG and NHS England at the end of last year. NHS England is now commissioning an independent review of the service.

One of the main criticisms is that patients who register with the service are automatically deregistered from their local GP, but are not specifically told so.

As previously reported by Computer Weekly, several London-based GP practices have been unhappy with the app, claiming that it tricks patients into deregistering from their local practice. Some practices have sent text messages to their patients discouraging them from registering with the on-demand service.

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