Having been given permission in June to expand its services to the Birmingham and Solihull area, GP at Hand was restricted to recruiting no more than 2,600 patients for the first three months.
But Hammersmith and Fulham CCG - which hosts the controversial digital-first service - has confirmed that GP at Hand will shortly be free to register additional patients subject to conditions.
GPonline revealed this month that GP at Hand now has the fifth largest registered list of any GP service in England. Figures for the start of August show that the total number of patients registered with the service is just shy of 60,000, after an 8,000-patient increase in the past three months alone.
The service has grown rapidly since opening its doors to patients outside its local area in November 2017, when the south-west London practice that hosts it had just 4,970 patients.
GP at Hand will be expected to establish a ‘robust automated solution’ to improve screening and access to local pathways, CCG officials have said. Should GP at Hand fail to find a solution by 15 September, the cap will remain.
Commissioners have agreed that restrictions on the geographical area in which GP at Hand can register patients will remain unchanged. A condition of the service’s expansion to Birmingham in June was that it could only recruit patients within the boundaries of Birmingham and Solihull local authorities.
Patients recruited from Birmingham are added to the same registered list as those from London - a list held through a subcontracting arrangement with a host practice in Fulham, London.
GP at Hand has also applied to open two new physical clinics in London, papers from the CCG reveal. The service, which currently operates five sites in the capital, will expand to seven when sites in Bloomsbury and Marylebone are opened.
Commissioners said the additional practices would allow GP at Hand to provide clinical services, such as cervical screening, from their own locations.
Hammersmith and Fulham CCG has reported ‘good progress’ on attempts to implement a solution to patient registration that would enable full access to local pathways and screening, but said the process had ‘yet to be completed’.
The rapid expansion of GP at Hand, which offers predominantly remote consultations via smartphone or computer, has been widely criticised by GP leaders.
The service has faced accusations of ‘cherry picking’ with nearly nine in 10 of its registered list aged between 20 and 39 years old. A review published earlier this year found that GP at Hand had attracted predominantly young, wealthy patients who use NHS services with above-average frequency despite being healthier than the average for their age.
Birmingham LMC executive secretary Dr Robert Morley has described the service’s expansion as ‘very concerning’, warning it could destabilise practices with younger populations, such as university practices.
The BMA has recently argued that GP at Hand should no longer be allowed to register patients because of the ‘considerable difficulties’ it caused neighbouring practices, calling for the service to become a partner to NHS 111.
Babylon GP at Hand has consistently denied cherry picking patients. A spokesperson said earlier this year: 'Many of our users joined us because they had an existing healthcare need but were faced with long waiting times or couldn’t make it to their previous GP - by using digital-first consultations these patients can get NHS GP appointments any time, any day, often within two hours of booking and at no extra cost to the NHS.'