Dear Secretary of State for Health and Social Care,
The advent of GP at Hand, the online NHS GP service, powered by Babylon, the private digital health provider service, has brought the problems of the ill-conceived government GP Choice Scheme into sharp focus.
Since GP at Hand launched in November 2017 around 26000 patients have registered with GP at Hand, most of these being between the ages of 20 and 39.
When patients register with ‘GP at Hand’ they are ‘de-registered’ from their own surgery and funding is then removed from that surgery. Practices have seen their list sizes fall for the first time in years due to those patients registering with GP at Hand. There is no doubt that ‘GP at Hand’ will destabilise other practices, robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients. Losing registration fees for younger, fitter patients who join ‘GP at Hand’ threatens the model of general practice relied on by so many patients. The scheme is hoovering up the younger, healthier patient and restricts access to those who are pregnant, frail, terminally ill or suffering from multiple health problems. Continuity of care is threatened because you may never see the same GP again when consulting GP at Hand.
In practice, 70% of all patients are reasonably well. Their funding helps surgeries care for the 30% who are sick. It’s a system that works, because it’s fair. We all eventually end up in the 30%.
The service targets the most profitable patients – those who are younger and healthier and don’t need extensive care from their GP. It is unclear if patients are fully advised of the implications of registering with ‘GP at Hand’ and how it can destabilise their previous practice by removing much needed funding.
Jeremy Hunt has said that general practice is the ‘jewel in the crown’ of the NHS. If he truly believes this, he will acknowledge that the ‘GP at Hand’ model threatens the very survival of NHS general practice as we know it and we call on him to abolish it. ‘GP at Hand’ have made it clear they wish to roll out their model of care across the country so this scheme will threaten general practice across England (Wales, Scotland and NI do not have this scheme in place).
Doctors in Unite demand that this aspect of the ‘GP Choice Scheme’ is abolished to ensure the survival of list-based NHS general practice within a defined geographical area. General practice is the cornerstone of the NHS which has provided excellent care with its other community partners for decades.
Signed by Dr Jackie Applebee and colleagues. Full list of signatories below
Doctors in Unite is part of Unite the Union, the largest union in the UK with 1.5 million members. We are committed to an NHS which is publicly funded, publicly provided and publicly accountable.If you are a doctor then join us in Doctors in Unite
Responding to the letter, a GP at Hand spokesperson told Pulse: GP at hand receives the same funding from the NHS as the vast majority of NHS practices do. The cross-subsidy allegation shows a failure to understand the basics of how NHS practices are funded. Capitation funding (the so called ‘global sum’) varies from below £35 per 15-44 man registered with a practice to over £190 for each person over the age of 85. And of course by providing care 24/7 despite only being paid for the core hours of 8am-6.30pm Monday-Friday, GP at hand is supporting the rest of the NHS as well as maintaining continuity of primary care within a single provider no matter what time of day or night.
The reality is 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. The 200 GPs who have already joined Babylon do so because they are treated with respect and not put under the levels of pressure all too common in other practices. 95% of Babylon doctors surveyed say ‘Usually, I can manage the amount of my work well.’ In comparison, the BMA showed in 2016 that 84% of GPs across the NHS reported that workload pressures are either ‘unmanageable’ or ‘excessive’ and having a direct impact on the quality and safety of the care they deliver to patients.
People have the right to choose their NHS practice. GP at hand is an NHS service; paid for by the NHS; providing NHS services to all patients – just like the vast majority of GP practices throughout the UK. In seven months, over 40,000 people living or working in central London have applied to join NHS GP at hand, with more than four out of five people rating our digital appointments giving them the full five stars. The average waiting time for an NHS GP appointment with GP at hand is 38 minutes, compared to waits for routine appointments in traditional practices of a week or more.
Name | Location | Job role |
---|---|---|
Jackie Applebee |
London Borough of Tower Hamlets |
GP |
Anu Mitra |
London |
Consultant in Emergency Medicine |
Mark Butler |
London |
Consultant Paediatrician |
Pam Wortley |
Sunderland |
Retired GP |
Dr Tim Dowson |
Newcastle |
General Practitioner |
Dr Gillian Breese |
North Wales |
Salaried GP |
David Church |
mid-Wales |
GP – salaried |
Prof Allyson Pollock |
Newcastle |
Prof of Public Health |
Dr Kambiz Boomla |
Queen Mary University of London |
GP academic |
John Puntis |
Leeds |
Consultant Paediatrician |
Beatrice Rogers |
Leeds LS16 |
Secretary Leeds Hospital Alert |
Penelope Jarrett |
London |
GP |
Dr Ben Hart |
Chrisp Street Health Centre, Tower Hamlets, London E14 |
gp |
Phillip Bennett-Richards |
Tower Hamlets |
GP |
Ian Jackson |
Tower Hamlets |
Health Partnership Director |
JOY FISHER |
leeds |
retired |
Bronwen Holden |
Leeds |
Retired Social Worker |
Wendy Savage |
Islington London |
Retired eniot Lecturer in Obstetrics and Gynaecology |
Dr J Price |
e3 2tj |
GP |
Sian Knight |
Lewisham, London |
General Practitioner |
Jo Downes |
Lincolnshire |
GP Practice Manager |
Emma Ovink |
Tower Hamlets |
GP |
Jim Cole |
Chrisp Street Health Centre |
GP |
Sifot Ali |
Bow |
GP |
Dr Kirti shah |
Grove rd surgery E3 |
Senior partner |
Amjad khan |
Bedford |
General practitioner |
Anna Livingstone |
Limehouse |
General Practitioner |
Rodrigo Correa |
London |
Business Manager |
Helen Berry |
West Yorkshire |
Hospital doctor |
Emily Graves |
Sunderland |
Consultant |
Timothy Yu |
London |
GP |
Sally Harrison |
Bristol |
Salaried GP |
Dr John Ward |
Bath, UK |
GP Registrar |
Rozhia Salih |
East Midlands |
Doctor |
Dr Peter Brooke |
Norfolk |
Paediatric Trainee |
Sara Swan |
Swansea |
GP |
Shakeeba Anwar |
Ashton under lyne |
Salaried GP |
David Ritchie |
South West |
Medical Doctor |
Vikram varma |
Wrexham |
Gp |
Dr Vicki Holtby |
Worcester |
Salaried GP |
Stella Johnson |
East of England |
Doctor |
Dr Veronika Wagner |
South East England |
Registered Medical Practitioner and Unite Workplace Representative |
Narin Shareef |
London |
Core medical trainee |
Sebastian Hormaeche |
London |
Anaesthetist |
Dr S Hafeez |
London |
GP |
Rob Molloy |
Birmingham |
GP |
Diana Lauder |
Wakefield |
Retired Nursing Sister |
Anam Ahmed |
Sheffield |
Junior doctor |
Dr Jennie Read |
Tower Hamlets |
GP |
Gwen Adshead |
Hampshire |
Hospital consultant |
Sarah Baines |
Lancashire |
Nurse, patient |
Dr Helen Cranage |
Liverpool |
GP registrar |
Amy jones |
England |
Emergency Medicine consultant |
Tom Wrigley |
Cambridge |
Gp |
Vikki Horton |
Portsmouth |
HSDU Technician |
Sue Horton |
Portsmouth |
Patient Services Assistant |
Christine Hunter |
Newquay |
GP locum |
Sorcha Mackay |
Scotland |
Specialty Doctor |
Sundus Ali |
Birmingham |
ST1 |
Monica Carter |
Lonfon |
Retired GP, volunteer doctor Freedom from Torture |
Jeanne Lintonbon |
London |
Doctor |
Hilary Kinsler |
London |
Old Age Psychiatrist |
Matthew ryan |
Cardiff |
Doctor |
Sian Ashby |
Herne Hill |
General Practice |
Peter English |
Surrey |
Public Health Physician |
Rebecca Mullen |
Tunbridge wells |
Doctor |
Isobel Leckie |
Norwich |
Bssw |
B Bhimarasetty |
Birmingham |
Gpst3 |
Lindsey Kent |
Salford |
Fy2 academic trainee |
Dr. Tiago Ivo |
Canterbury |
Doctor |
Krishnaveni Padala |
Preston uk |
Sho |
Alan Courtney |
England |
Doctor |
Dr Christopher Butler |
Shipley, West Yorkshire |
Retired GP |
Simon Lawrance-Owen |
Gloucester |
GP Trainee |
Anisha Antony |
Sheffield |
GP |
Hannah Woodcock |
West Suffolk |
Junior Doctor |
Dr Julian Bashforth |
Hampshire |
GP |
Raina nazar |
Sutton Coldfield |
GP |
Naomi Beer |
Tower Hamlets |
GP |
Caroline Worsley |
Sheffield |
Doctor |
Andy Atkins |
Leeds |
Retired |
Caroline Cocking |
Derbyshire |
Registered nurse |
David Topliss |
Oxfordshire |
Consultant |
Jennifer Barclay |
Salford |
Foundation Year 2 Doctor |
Jeanne Jackson |
Greenwich, SE3 |
RETIRED |
Martin Seager |
Saffron Walden |
Clinical Psychologist |
Dr Robert Morley |
Birmingham |
Local Medical Committee Secro |
Judith Kelly |
Birmingham |
Biomedical Scientist |
Hannah Robinson |
Cornwall |
Occupational therapist |
Kathryn McAdam Freud |
Southwark |
GP principal and trainer |
Rebecca Leslie |
Dundee |
Paediatric Consultant |
Mary Church |
Bothwell |
GP |
Kathryn McAdam Freud |
Southwark |
GP partner and trainer |
Sue Butters |
Norwich, Norfolk |
clinical research nurse |
Maureen Huddleston |
Lancaster England |
Nurse |
Dr Stefan Lipinski |
SE London |
Gp partner |
Phillip Welldrake |
Stockport |
retired |
Edoardo Cervoni |
Southport |
GP |
Diana Lauder |
Wakefield |
Retired Nurse |
Beverly Fernado |
Tower Hamlets |
Practice Manager |
Hina Din |
Newham |
Practice Manager |
Nitin Shori |
Wales |
GP Partner |
Dr Prakash Kachhala |
Nottingham |
GP Partner |
Siobhan Stapleton |
Greenford |
GP |
Karen Haworth’s |
Medway, Keny |
GP |
Dr Helen Lever |
East Midlands |
GP |
Ruth Marchant |
london |
GP |
James Morgan |
Caerphilly |
GP practice manager |
Preethi Perera |
Surrey |
GP |
Kerry Sneddon |
Glasgow |
Gp |
Siobhan gillespie |
Devon |
Gp |
Sarah Johns |
Nottingham |
GP Partner |
Jaspal Taggar |
Nottingham |
Associate Professor and GP |
Judith Bull |
Abbots Bromley |
Senior Partner |
Sarwat shah |
London |
Locum consultant |
Emma Willert |
Sale, Cheshire |
GP |
Julie Boissonade |
Cornwall |
GP |
Adele Parsons |
Lincoln |
Advanced Nurse Practitioner |
Dr Tamsin |
Cirencester |
Gp |
Michelle Teo |
London |
Doctor |
Sarah Sanaghan |
Glasgow |
GP |
Dr Ben Bromilow |
London |
GP Partner |
Rob Gardiner |
cambridgeshire |
nurse practitioner |
James Crane |
London |
Clinical Research Fellow, Obesity |
Hugo Farne |
London |
Registrar in Respiratory Medicine |
Amit Shukla |
Lincoln |
Consultant Surgeon |
Andrea English |
West yorkshire |
Advanced nurse practitioner |
Karam Sarsam |
South London |
Doctor |
Dr Tejumola Olaoye |
Birmingham |
ST4 O&G |
John Hewertson |
East Midlands |
Consultant Paediatricians |
Heather Mycock |
Winchester |
Retired GP |
Mary Valentine |
Royal Wootton Bassett |
GP |