The NHS Long Term Plan pledges that every patient will have the right to be offered digital-first primary care by 2023/24, and NHS leaders are now proposing a raft of rule changes to contain and focus the impact of rapidly expanding digital services.
A consultation on the plans, which was launched in June this year, is due to close on 23 August. You can find out more and submit your views here on digital-first primary care.
NHS England has suggested that services offering primarily video consultations via a smartphone app may be allowed to expand in the 10% or 20% of CCG areas with the least GPs, and could help reduce health inequalities.
Other proposals include changing the way CCGs are funded to allow for more regular movement of patients, making it easier for existing practices to set up and expand digital services, and forcing digital-first providers to set up physical practices in areas once they attract a threshold number of patients.
Digital-first primary care
But one of the key findings of a recent evaluation of Babylon GP at Hand - a digital-first service that has attracted more than 50,000 NHS patients in London - was that it had registered predominantly young, affluent, healthy people who were nonetheless relatively high users of healthcare services.
The BMA’s GP committee chair Dr Richard Vautrey has warned that the proposals could result in a two-tier service that means patients in deprived areas will lose out on face-to-face consultations to address complex problems that need proper time with healthcare professionals.
The key proposals are to:
Amend the out-of-area registration rules so that where a practice exceeds a threshold number of out-of-area patients in any CCG, they would separately be awarded a local APMS contract in that CCG;
Change the allocations system to enable quarterly recalculation of CCG funding to reflect patient movements;
Amend the new patient premium so that it is only paid if a patient remains registered with a practice for a defined period;
Allow new digital-first practices to be established in the most under-doctored geographies to increase overall GP capacity and address the inverse care law in general practice.
Download the supporting documentation here.