NHS England to have final say on GP at Hand expansion

NHS England could make the final decision on whether the GP at Hand service should be allowed to expand beyond London and has suggested a proposed Birmingham service should remain blocked at this stage, CCG board papers reveal.

GP at Hand: smartphone consultations (Photo: iStock.com/oatawa)
GP at Hand: smartphone consultations (Photo: iStock.com/oatawa)

Papers being discussed on Tuesday at a Hammersmith and Fulham CCG board show that NHS England has raised concerns about screening and 'access to clinical pathways'.

NHS England's London directorate has advised the CCG - which hosts the existing GP at Hand service - that while concerns about access to clinical pathways could be resolved, 'currently there is not a satisfactory or sustainable solution to ensure that patients will be able to participate in screening easily'.

Until this is resolved, GP at Hand’s potential expansion outside of London should remain blocked, NHS England has advised.

GP at Hand

Hammersmith and Fulham CCG are due to meet later today to consider whether or not to lift a decision made last month to block GP at Hand’s expansion to Birmingham.

However, board papers suggest that NHS England could now have the final say on the matter due to the ‘novel, contentious or repercussive’ implications of any decision to allow the expansion of the controversial service, which relies on technology from private provider Babylon.

The board papers said that, despite receiving a number of assurance submissions from Babylon, there continued to be ‘outstanding concerns regarding access to clinical pathways and arrangements’ for GPAH patients accessing screening services.

Patient safety

The papers say: 'The committee is invited to consider whether the patient safety and compliance issues identified at its previous meeting have now been satisfactorily resolved (such that the committee no longer considers that the variation to the sub-contract would put the safety of GP at Hand’s patients at serious risk or that the sub-contractor would be unable to meet GP at Hand’s obligations under the GMS contract) or whether further assurance is required.'

NHS England will then be approached for approval in line with a clause in delegated commissioning arrangements relating to decisions with 'novel, contentious or repercussive' implications. The board papers add: 'The notice of objection will remain in force unless and until such further decision is taken by NHS England and the CCG.’

Following a decision last month to block expansion of GP at Hand, a spokesman for the service said it was 'shocked and disappointed' by the way Hammersmith and Fulham CCG had reached the decision. The spokesman said blocking the rollout 'denies people across Birmingham the opportunity to choose an NHS GP practice providing 24/7 GP appointments within two hours and misses a golden opportunity to reduce pressure on GPs and A&Es across Birmingham'.

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