Pollsters handed £250,000 contract to investigate impact of GP at Hand

A market research firm carrying out a £250,000 investigation into the impact of the controversial GP at Hand service - including its long-term implications for the sustainability of traditional general practice - will publish initial findings by autumn.

GP at Hand investigation underway (Photo: iStock/GiulioFornasar)
GP at Hand investigation underway (Photo: iStock/GiulioFornasar)

Ipsos Mori won a £250,000 contract put out to tender by Hammersmith and Fulham CCG and NHS England earlier this year, and began its investigation from the start of June. It will deliver a final report by March 2019.

The company will be expected to report back on the impact of GP at Hand on 'other GP practices and their patients', considering how the demographics of patients attracted to the service affect the finances of surgeries that they leave.

It will consider the consequences of GP at Hand for the Carr-Hill formula, which defines how much GP practices are paid, and the consequences of the video consultation service for the 'short- and longer-term quality, profitability, sustainability of the traditional GP, and the quality of the service they can afford to provide'.

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How does the GP at Hand service work?

GP leaders have called on health secretary Jeremy Hunt to 'pull the plug on GP at Hand, warning that its rapid growth has exposed flaws in the GP out-of-area registration scheme, which the service has used to attract patients from a wide geographical area.

The invitation to tender for the contract says that 'the evaluation should answer a set of research questions around the impact of the service on users, non-users, the wider health and social care system, and the workforce'.

The investigation will look at how GP at Hand - which has attracted tens of thousands of mainly young patients over the past six months - affects the safety of patient care, patients' experience of care, whether it is equitable for patients, and whether the service is effective from a healthcare point of view and financially efficient.

It will consider factors such as whether patients are aware of the significance of having to deregister with their existing GP to sign up with GP at Hand, journey times when patients need face-to-face appointments with the predominantly online service, and how the service affects the frequency of patients' use of healthcare.

NHS contract

The invitation to tender admits that NHS leaders have a 'limited' understanding of the controversial scheme, which has seen around 25,000 patients quit their existing GP and switch over to it since November 2017 - a huge shift that has left the local CCG facing an £18m hole in its finances.

The document says: 'The GP at Hand practice’s offer to patients is new, and our understanding of how it works, how people use it, and what implications and outcomes this will have is limited. For example, there may be reasons to expect GP at Hand to both decrease attendances at A&E/ UTCs (due to quicker access to primary care), and to increase attendances at the same place (due to longer distances to travel to a face-to-face appointment – potentially past an A&E). The successful bidder will therefore need to develop a research methodology that is able to cope with this uncertainty.'

The report to be produced by Ipsos Mori will also consider whether the rollout of GP at Hand could drive other practices to innovate, how the services affects the quality of care, overall NHS costs, referral patterns, and the workforce - including whether the services is attracting GPs away from traditional practices.

The BMA has accused the GP at Hand service of cherry picking younger patients, because the service places restrictions on who can join and the vast majority of its new patients are aged between 20 and 39 years old.

However GP at Hand and Babylon, the company whose technology it relies on, have said repeatedly 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'.

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