Under the five-year GP contract agreement unveiled last week it will ‘no longer be legal for any NHS GP provider - either directly or via proxy - to advertise or host private paid for GP services that fall within the scope of NHS-funded primary medical services'.
NHS England has promised full guidance 'in due course' to clarify how the policy will be implemented in practice. For the small proportion of GP practices believed to operate private patient lists - a service they have until now been permitted to offer to anyone not on their NHS list - the new rules are understood to constitute a ban on these private services operating from premises used for NHS work.
However, GPC chair Dr Richard Vautrey has said the rise of digital services was a key driver behind the new rules, citing 'increasing blurring in recent years between NHS and private GP services offered to patients, particularly with the opportunities digital technology is providing'.
Private GP services
He told GPonline: 'Providers need to make a choice, they either provide NHS GP services or private GP services, but they can't do both.'
Asked whether this would affect providers such as Babylon - which delivers a private GP service as well as operating the widely-publicised NHS service now officially named Babylon GP at Hand - Dr Vautrey said: 'This is what NHS England will now be looking at.'
A spokesperson for Babylon GP at Hand said: 'Babylon GP at hand is a full NHS general practice, and offers no private services to patients on our list that are within the scope of NHS-funded primary medical services. Whereas patients at practices with long waiting times may understandably seek private GP appointments, people joining Babylon GP at Hand have 24/7/365 access to NHS GP appointments within two hours.'
Whether the new rules could affect Babylon's - or other digital first providers' - ability to use the same locations to offer face-to-face appointments for private and NHS patients, for example, or have the same staff taking calls for both services, remains unclear.
Tower Hamlets LMC chair Dr Jackie Applebee told GPonline she believed Babylon GP at Hand may have to change to fit with restrictions on advertising services.
'The new contract says that it will no longer be legal for any NHS GP provider to advertise private paid for GP services. So it seems to me that Babylon should not be branding GP at Hand as "Babylon GP at Hand" because this, in my opinion, falls foul of that clause in the contract.'
She pointed out that the logo for Babylon appeared on both the website for its NHS GP at Hand service and its private service website. 'I do not think it is acceptable that GP at Hand is known as Babylon GP at Hand,' said Dr Applebee. 'If you travel on the tube in London there are adverts all over the place for GP at Hand, with the NHS logo and the Babylon logo.'
The east London GP added that Babylon 'must conform' with whatever is expected of other practices. 'There cannot be one rule for them and another for the rest of us,' she said.
NHS free at point of delivery
An NHS England spokesperson said: 'Our aim is to reinforce the principle that the NHS should be free at the point of delivery; provide clarity and reassurance for patients; and support practices to deliver essential services under the NHS to their registered patients. As set out in the new GP contract effective from April 2019 we will be issuing guidance on implementing this in due course.'
Dr Richard Vautrey said: 'We have been concerned at the increasing blurring in recent years between NHS and private GP services offered to patients, particularly with the opportunities digital technology is providing. This change will provide clarity for patients about what treatment is available on the NHS and what they have the option of paying for privately. As part of this agreement NHS England will consult on how this rule can be expanded to include other NHS providers, including hospitals and pharmacies.
'We do believe NHS England and government need to tackle this growing problem and this agreement provides the basis to do so. Providers need to make a choice, they either provide NHS GP services or private GP services, but they can't do both.'