NHS patients given option to switch to smartphone GP service

GP at Hand service to roll out across London, but Royal College of GPs criticises scheme for ‘luring doctors away from the frontline’

NHS patients are being offered the chance to swap their current GP for an app-based service offering round-the-clock video consultations.

But the Royal College of General Practitioners (RCGP) has warned that the move could create a “twin-track” NHS which negatively impacts traditional community doctors and their most vulnerable patients.

Following the successful completion of a trial in the London Borough of Hammersmith and Fulham, The GP at Hand service is now being rolled out across the capital. The service, which is being run in partnership with technology company Babylon Health, allows patients to use a smartphone app to book appointments and conduct consultations with NHS GPs via videoconference.

Appointments are available round the clock, every day of the year, and GP at Hand claims patients will, typically, be able to talk a doctor within two hours. If patients subsequently require a face-to-face consultation, they can make appointments to see a GP at a network of London surgeries that currently numbers six, with locations in Victoria, Euston, Poplar, Whitechapel, and two in Fulham. These appointments, which GP at Hand claims are usually available by the end of the following day, are offered from 8am to 8pm on Monday to Thursday, and from 8am to 6.30pm on Fridays, and 8am to 5pm on Saturdays.

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Further London surgeries will be added in due course and the scheme will roll out “across the country in the near future”, Babylon said.

Prescriptions can be immediately sent out to any pharmacy of the patient’s choosing.

Jane Barnacle, director of patients and information for NHS England London region, said: “GP practices are right to carefully test innovative new technologies that can improve free NHS services for their patients while also freeing up staff time. The NHS is now developing modern new treatment options for our patients, recognising that one size does not fit all when it comes to primary care.”

Patients wishing to join up to the app-led service must leave their existing GP, with their records transferred over to GP at Hand. 

An NHS review has found “that the service may be less appropriate” for patients with certain conditions, needs, or life circumstances. Such conditions include pregnancy, dementia, “complex mental health conditions”, frailty, and drug dependence. Adults with safeguarding needs, people with learning difficulties, those living with “complex physical, psychological, and social needs”, parents with children on the child protection register, and those requiring end-of-life care are also advised to seek advice before signing up with GP at Hand.

RCGP criticisms
The service’s lack of suitability for these people is one of several misgivings voiced by Helen Stokes-Lampard, chair of the RCGP, who said that dealing with the conditions listed above is “the essence of general practice”.

“Some patients will see this as a golden ticket to get quick and easy access to a GP. And, for younger, healthier commuters, it could prove a solution to long waiting times for an appointment,” she said. “Technology can achieve wonderful things when used properly, but we are really worried that schemes like this are creating a twin-track approach to NHS general practice and that patients are being cherry-picked, which could actually increase the pressures on traditional GPs based in the community.”

Stokes-Lampard added: “We understand that, with increasingly long waiting times to see a GP, an online service is convenient and appealing, but older patients and those living with more complex needs want continuity of care and the security of their local practice where their GPs know them.”

The RCGP chair also expressed concern about the administrative burden of people moving to and from the GP at Hand service, as patients are allowed to switch back to their previous GP if they find that they are not satisfied with the digital service.

“As well as issues with patient confidentiality and the safety of the patient record, it is hard to see how this could be achieved without adding to the huge burden of red tape that GPs are already grappling with,” she said.

“While this scheme is backed by the NHS and offers a free service to patients, it is undoubtedly luring GPs away from frontline general practice at a time when we are facing a severe workforce crisis, and hard-working GPs are struggling to cope with immense workloads.”


Sam Trendall

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