LMCs call for out-of-area registration to be abolished amid GP at Hand fears

LMCs have called for the controversial out-of-area registration scheme to be scrapped amid fears over the impact of GP at Hand.

(Photo: iStock.com/PeopleImages)
(Photo: iStock.com/PeopleImages)

A motion listed for debate at this year’s England LMCs conference, which takes place in London on 23 November, has called for the abolition of the out-of-area registration clause in the GMS contract which underpins Babylon’s GP at Hand model.

LMC leaders will argue that 'the rise of out-of-area alternate primary care providers has the potential to destabilise the local health economy, threatening the viability of the current model of general practice’. They will also urge the government to halt the roll out of such models until their impact has been assessed.

Last week CQC chief inspector for general practice Professor Steve Field confirmed that the watchdog would be ‘looking at the surgeries that might be impacted’ by online providers to assess whether they have had a ‘destabilising effect on the wider system’.

Ipsos Mori is also currently conducting an investigation into the impact of GP at Hand, including the long-term implications for the sustainability of traditional general practice, on behalf of Hammersmith and Fulham CCG which hosts the service.

GP at Hand

Currently, patients who register with GP at Hand - which has attracted more than 30,000 predominantly young patients over the past year - are required to quit their existing practice and sign up as out-of-area patients with the service’s host practice in south-west London.

The service limits registrations from patients likely to have complex needs, which has led to accusations of ‘cherry picking’ and concern that the model could destabilise traditional practices, which rely on funding for younger patients to cover some of the cost of providing care for complex older patients.

At this month's conference, LMCs will also vote on whether to instruct the GPC to ‘insist that all providers must offer and deliver a full range of services, equitably, to all patient groups without any exceptions based on age, sex and morbidity or technological competence’.


LMC leaders will also express their displeasure at health and social care secretary Matt Hancock's endorsement of GP at Hand.

Mr Hancock, who is a GP at Hand patient, faced criticism from GP leaders earlier this year for saying he wanted the service to be available to all patients in England.

The health secretary went on to make an appearance at Babylon's headquarters in London, where he said he wanted 'loads of companies' to follow GP at Hand's example.

LMCs will say they are 'shocked and dismayed' by Mr Hancock's ‘flagrant endorsing of the GP at Hand model’. They will call upon him to 'publicly retract his comments that GP at Hand was "good for NHS patients, clinicians... and relieved pressure on other NHS services" until such a time as the report commissioned by his own ministerial department is completed'.

GP leaders will also say that they 'cannot have confidence in [Mr Hancock] if he continues to demonstrate his ignorance of the value, worth and function of general practice by his support for a virtual system incapable of providing holistic care'.

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