Jeremy Hunt urged to pull plug on GP at Hand service

GPs have called on health secretary Jeremy Hunt to scrap the out-of-area registration scheme that has allowed the controversial GP at Hand service to attract thousands of young patients in just a few months.

Doctors in Unite chair Dr David Wrigley
Doctors in Unite chair Dr David Wrigley

Campaigners have written to the health secretary warning that the rapid growth of GP at Hand has destabilised other practices and brought 'into sharp focus' flaws with the 'ill-conceived' out-of-area scheme - known as GP Choice.

The Lillie Road Medical Centre in Fulham, where patients register to use the GP at Hand service, saw its list size grow from 2,500 in April 2017 to 24,652 on 1 March 2018 - with the vast majority of new patients aged between 20 and 39 years old. Hundreds of patients quit the service in March, but its list size remains at around 24,000.

Hammersmith and Fulham CCG has warned that the rapid rise in patients at the practice - most of whom live outside the local area - could leave it facing a £10m deficit by the end of 2018/19.

Practices destabilised

The letter to Mr Hunt, signed by Doctors in Unite chair Dr David Wrigley, along with deputy chairs Dr Jackie Applebee and Dr Coral Jones, warns: 'When patients register with GP at Hand they are de-registered from their own surgery and funding is then removed from that surgery. Practices have seen their list sizes fall for the first time in years due to those patients registering with GP at Hand.

'There is no doubt that GP at Hand will destabilise other practices, robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients.

'Losing registration fees for younger, fitter patients who join ‘GP at Hand’ threatens the model of general practice relied on by so many patients.' Doctors in Unite is calling on the health secretary to scrap the GP Choice scheme to protect general practice.

Responding to concerns set out in the letter, a spokesman for GP at Hand and Babylon - the company whose technology allows the service to offer video consultations - said: 'In less than six months, over 40,000 people living or working in central London have applied to join NHS GP at Hand, with more than four out of five people rating our digital appointments giving them the full five stars.

GP funding

'Babylon has a sub-contract with the GP at Hand practice, which receives the same funding from the NHS as the vast majority of NHS practices do. Capitation funding (the so-called "global sum") varies from below £35 per man aged 15-44 registered with a practice to over £190 for each person over the age of 85.

'The reality is 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. The 200 GPs who have already joined Babylon do so because they are treated with respect and not put under the levels of pressure all too common in other practices.

'Both Londoners and GPs clearly like GP at hand, which as a free-at-point-of-need NHS service, extends 24/7 primary healthcare access to more members of the public.'

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