Mr Hancock told the National Association of Primary Care (NAPC) annual conference on Thursday: 'There’s parts of the system that don’t work - parts of the rules that don’t work with or for this new technology and we need to change those rules to make sure that the technology can benefit patients but also doesn’t undermine others in the system with unintended consequences.’
The health secretary said he understood concerns that the rollout of systems such as GP at Hand could destabilise general practice. Asked whether services of this type 'arguably create a two-tier health system in that it creams off the rich, the healthy and leaves [other] practices with the poor and the sick', Mr Hancock said: 'I understand that critique.'
He acknowledged problems 'trying to fit into a financing system' a model that draws patients from a far broader area than a standard practice. The 30,000-plus patients who have signed up for GP at Hand have all been registered with a single practice in west London, triggering major financial disruption for the host CCG.
Mr Hancock acknowledged that as far as the funding system was concerned, it was as if ‘they’ve all moved to Hammersmith and into one CCG’.
The health and social care secretary’s comments came as a top NHS official revealed how individual patient data could underpin a future overhaul of the funding model for general practice.
NHS England deputy chief executive Matthew Swindells told the conference that a GP funding system based on accurate data on individual patients 'has to be the direction of travel'.
Changes to the way ‘digital-first’ providers of primary care are funded could take effect from April 2019, under proposals consulted on earlier this year by NHS England.
Proposals published in July could see funding for digital-first providers slashed by almost 20%. NHS England said at the time that ‘one of the challenges is ensuring that the way we commission, contract and pay for care keeps up with the opportunities digital innovation offers – ensuring that new technology is safely integrated into health and care pathways, whilst not unfairly destabilising existing services’.
The document acknowledged concerns that ‘the rapid expansion of digital-first practices is leading to patient selection effects not being adequately captured in the GP funding formula.'
Mr Hancock added: 'Technology has to work for you - the clinicians and the professionals - and we have to make sure that if we need to change the rules to work with the new technology then change the rules we must.'
Mr Hancock also told the conference on Thursday that the balance of NHS funding would tip in favour of general practice as the extra £20bn coming into the NHS budget over the next five years kicked in.