LMCs demand out-of-area rules are scrapped and slam Hancock over GP at Hand

GP leaders have called for out-of-area registration to be scrapped and said they cannot have confidence in health secretary Matt Hancock if he continues to support GP at Hand.

Delegates at England LMCs conference today voted to instruct the GPC to negotiate the abolition of the out-of-area registration clause in the GMS contract, which has enabled Babylon to set up GP at Hand.

LMC leaders also called on Mr Hancock to retract his comments that GP at Hand was 'good for the NHS and patients', saying they could not have confidence in him if he continues to 'demonstrate his ignorance of the value, worth and function of general practice' by supporting the service.

In his speech to the conference earlier, GPC chair Dr Richard Vautrey said that the out-of-area regulations were being ‘exploited for profit rather than delivering comprehensive quality care’.

He added that policymakers and politicians were waking up to the ‘damage’ that the GP at Hand model could do to community-based general practice.

GP at Hand

Dr Brian McGregor from North Yorkshire said that GP at Hand ‘disregarded’ the principles of general practice by discriminating against certain groups of patients.

The service uses the rules surrounding out-of-area registration to restrict access to patients with more complex needs, including pregnant women, those with dementia, patients with learning disabilities and those with long-term conditions. This has led to accusations of cherry-picking and concerns that the service could financially destabilise other practices.

Dr McGregor said the conference wanted Mr Hancock to ‘retract his support for an unproven and discriminatory service until full evaluation is available and to invest in the support and software systems used by GPs every day that regularly fail.’

‘We hope he understands the profession truly welcomes the change in secretary of state for health and social care, but cannot have confidence in yet another politician who openly supplies endless rhetoric but then completely fails to understand the true value, worth, function and integrity of holistic care and professional general practice,’ Dr McGregor added. ‘We in desperate need of solutions to increase our resources not deplete them further.’

Dr Chris Hunt from Devon LMC said that new online technologies should be embraced by GPs. But he added: ‘These new services must be commissioned properly and available for all and no more cherry picking – and most importantly no chance of destabilising traditional primary care. If this can’t be achieved then I suggest they should remain in the private sector.’

Delegates also warned that adoption of any new technology needed to be evidence-based. Dr Bethan Rees from Hertfordshire LMC said: 'The future is technology and GP needs to embrace it. But online consultations need to be evidence based... there is no evidence that it is safe and effective or improves access.'

'Poor form'

GPC executive member Dr Farah Jameel said that in her personal view it was ‘poor form on the part of the secretary of state’ to endorse the GP at Hand model. She said that the GPC had raised concern about this directly with Mr Hancock in meetings.

In his speech, Dr Vautrey told the conference: ‘Most practices would want to be able to offer smart phone video consultations if they had the bandwidth to support it as it’s probably safer than the many telephone consultations we already do. But none of us are in the business of turning away patients who are too old, or frail, or sick, or mentally ill.

'We deliver a comprehensive, holistic service, catering for all people whatever their needs. And we embed our service in a local community, with staff from that community, not from a call-centre in Soho. 

'If NHS England is serious about supporting the development of primary care networks, of developing a genuine collaboration of local health care providers working together with a common aim for the benefit of people in their community, then they must scrap the out-of-area registration regulations that are exploited for profit rather than delivering comprehensive quality care.'

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