A Babylon spokesperson told GPonline that given its 50,000-patient registered population the service was ‘well placed to be a primary care network’ (PCN) and that the service was on track to meet the 15 May deadline for completing the registration process to form a PCN. The spokesperson said that other practices may be invited to join the network.
Under the five-year GP contract agreement published earlier this year, all GP practices in England are expected to join PCNs - with standard networks covering populations of 30,000-50,000 patients.
A total of £1.8bn in funding for general practice will come through PCNs over the next five years - with a standard-size network set to receive around £180,000 in 2019/20 according to the BMA. PCNs are expected to become operational from July - and all patients in England must be covered.
GP at Hand
But GP leaders have questioned how GP at Hand can form a network given that its patients live across a wide geographical area - and given that the service has been given permission to expand to Birmingham.
The five-year GP contract agreement describes PCNs as ‘the natural unit for integrating most NHS care’. It says that ‘collective general practice can become the footprint on which other NHS community-based services can then dock’ - and crucially that ‘by serving a defined place, the PCN brings a clear geographical locus for improving health and wellbeing and community leadership’.
GPC chair Richard Vautrey said the idea of a digital first provider - with large numbers of patients who live far from the physical location where they are registered - forming a PCN was ‘completely at variance with the model the NHS is promoting elsewhere’.
‘The idea of place-based commissioning and all the benefits that will bring, that agenda we are committed to and support due to the benefits for patients - the out-of-area remote working model that digital first providers are based on are completely at variance with that. This is something that needs to be thought about very carefully.’
Dr Vautrey said he hoped concerns around this could be addressed as part of a review of out-of-area patient registration rules and digital first services promised in the five-year contract deal.
Londonwide LMCs chief executive Dr Michelle Drage said plans for GP at Hand to form a PCN could ‘disrupt the system to the point of destruction, with the consequence of further destabilising all current NHS services in London as GP, community and hospital funding moves to covering people in clearly defined geographical areas’.
Dr Drage warned: ‘In accordance with the Network DES, negotiated nationally between the BMA's GPC and NHS England, commissioners have been clear to local GP practices that their networks must exist inside contiguous boundaries. We ask the CCG, NHS England and the health secretary - who is a registered patient and public advocate for Babylon GP at Hand - will all GP practices and networks be governed by the same rule book?’
A Babylon spokesperson said: ‘With the strong links already formed with community providers, and nearly 50,000 registered patients, Babylon GP at Hand is well placed to be a primary care network. This network may of course also include other practices that share the vision of highly accessible, high quality care.’
A total of seven PCNs are understood to be under consideration in the Hammersmith and Fulham CCG area where GP at Hand is based - six conventional networks and the GP at Hand proposal.
A Hammersmith and Fulham CCG spokesperson said: ‘The practices within Hammersmith and Fulham CCG are continuing to have ongoing discussions about the network configuration.
‘Some of the emerging networks are more defined at this point than others. As you will be aware the CCG has a facilitative role in this and we are encouraging practices to have discussions about the network form and function to ensure that the network criteria and aspirations for the five-year framework are met.
‘This includes the Babylon GP at Hand practice. We will continue to facilitate discussion on network options with the practice, neighbouring practices, the Hammersmith and Fulham GP federation and NHS England on this.’