GP at Hand CCG likely to receive NHS England bailout as costs soar by £18m

The CCG hosting GP at Hand needs an £18m bailout from NHS England to cover costs triggered by thousands of young patients joining the service - and believes it is 'likely' to receive financial support within 2018/19.

NHS officials at Hammersmith and Fulham CCG, in west London, warned in March that the rapid expansion of GP at Hand could leave it facing a £10m budget deficit in 2018/19.

Board papers published this month suggest that the cost could be higher still, with the CCG warning that its financial plan for 2018/19 'requires £18m of external support from NHS England to cover the GP at Hand accelerated costs'.

The CCG says it finished 2017/18 with an above-target surplus of £1.25m, but warns this was only possible by 'drawing down' £3.9m accrued from underspending in previous years.

GP at Hand

Hammersmith and Fulham CCG's board papers say that talks have been ongoing with NHS England over the 'financial impact on the CCG of the list size growth of the GP at Hand practice'.

The CCG reports that progress was being made, and that 'there is likely to be an agreement with NHS England on some financial support to the CCG within this financial year'.

Although the patient list at the Lillie Road Medical Centre, where patients sign up for GP at Hand, fell in the month to 1 April, the service currently has almost 24,000 patients - up from just under 5,000 last November. A spokesman for GP at Hand said last month that registrations were expected to surge again in April.

The CCG has warned that the rapid growth of the service and the movement of many thousands of predominantly young patients risks destabilising other practices in London.

Patient registration

Patients who register with GP at Hand are required to quit their existing practice and sign up as out-of-area patients with the Lillie Road practice.

The service restricts registrations from patients likely to have complex needs, such as pregnant women or those with some long-term conditions, leading to accusations of cherry-picking. Patients who sign up can receive video consultations remotely, or face-to-face consultations if needed at locations around London.

Hammersmith and Fulham CCG board papers also confirm that an announcement will be made 'shortly' on who will carry out a planned independent evaluation of the GP at Hand service.

Campaigners last month urged health secretary Jeremy Hunt to pull the plug on the GP at Hand service, warning that it put existing GP services at risk and highlighted flaws in the ill-conceived out-of-area 'GP choice' scheme.

A spokesman for GP at Hand and Babylon, the company whose technology it relies on, said at the time that 'patients and GPs are flocking to GP at Hand because they recognise the potential that high quality, digital-first 24/7 NHS GP services bring'.

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