UPDATE Health Secretary blind to £35M impact of Babylon’s ‘GP at Hand’ Service
Matt Hancock accused of “wholly untrue” Parliamentary answer dismissing local MP’s plea for cash-strapped Clinical Commissioning Group
In Parliament this week Andy Slaughter MP asked Health Secretary Matt Hancock when a £35M shortfall in the NHS budget of his constituency, Hammersmith and Fulham, would be met. GP hours in his constituency have had to be cut and an urgent care centre is about to be closed, Slaughter said, claiming much of the shortfall was due to the impact of privatised online GP services on the NHS, particularly the GP at Hand app produced by Babylon Healthcare.
what the papers don’t say
Due to what local MP Andy Slaughter calls a ‘loophole’, the outsourced service is able to register its patients to just one small Fulham GP’s surgery, Dr Jeffries and Partners, where he said there are an extra 45,000 patients as a result.
Hancock replied that Hammersmith and Fulham has already got additional funding and that GP at Hand’s contract has been revised to better suit the NHS.
Slaughter told Byline Times that this is simply incorrect about the NHS funding: “GP services are being cut not increased in Hammersmith and Fulham. Hancock’s statement was wholly untrue.”
Distorting Primary Care
As Byline Times reported recently, the arrival of the online GP at Hand App has rapidly distorted the NHS market for primary care. The App’s success in advertising and attracting new patients resulted in a staggering 1820% growth of its patient list since 2017, de-registering them from their previous GPs in the process.
This ostensibly brings associated fees out of the NHS budget. GPs get a yearly NHS payment for every patient on their list, the national average is £152.05.
However, in this case, the movement of patients has been rapid. Only 10% of GP at Hand’s users are from its local area as the App is using the ‘out of area rules’ to serve patients anywhere online.
Hammersmith and Fulham CCG has had to pay Babylon for patients who signed up to the outsourced service up-front, but is now struggling to recoup that cost from other CCGs who are resisting the changes.
Slaughter says other Clinical Commissioning Groups are resistant to losing their ‘most profitable’ — young, healthy, tech-savvy — patients. The money simply is not there for Hammersmith and Fulham CCG to fill the deficit it has incurred by paying Babylon Health. GP hours in Hammersmith and Fulham have been cut, and an Urgent Care Centre in could be closed before the end of the month.
Meanwhile, Babylon has got permission to expand its service into Birmingham and is applying to be its own ‘Primary Care Network’, raising concerns that the distortion to the NHS Primary Care Market will continue unabated.
Slaughter has responded to the crisis by calling for a parliamentary inquiry into Babylon’s online service. He points out that the mass movement of predominantly tech-savvy younger, healthier patients is causing financial ripple effect across NHS primary care.
Slaughter explains: “The problem is there is this loophole that allows a service like Babylon to link up with one GP and expand its service nationwide. Hammersmith CCG has to fund the GP at Hand list [of patients] up front. In theory the money should follow the patient – but that can take a year or two.”
The emergence of digital-first providers, which register patients who may live some distance from the practice, raises the question of whether these funding arrangements are fair.Department of Health and Social Care
Hammersmith and Fulham Clinical Commissioning Group reported that in 2017-18, GP at Hand cost them two to three million. In the 2018-19 financial year, GP at Hand cost them £10.5 million, and it is projected to cost them 21.8 million from the current financial year.
Slaughter asked Hancock on Tuesday when that money will be found. Hancock appeared unsympathetic: “I do not recognise the number that the honourable Gentleman talks about.”
Hancock claimed: “we are changing the way in which the GP contract works to ensure that this new technology can be most effectively harnessed to deliver patient need in a way that also works for the NHS.”
A Spokesperson for Department of Health and Social Care confirmed that recent changes to how funding works have not been specific to Hammersmith and Fulham or to GP at Hand. However as ‘funding follows the patient’: “Hammersmith and Fulham CCG will see its funding grow to cover the additional registered population caused any expansion of GP at Hand”.
The Spokesperson told Byline Times:“The emergence of digital-first providers, which register patients who may live some distance from the practice, raises the question of whether these funding arrangements are fair.” This is based on the ‘out of area rules’ , which ‘were not designed with digital registration in mind, and they need to be revisited’.