GP at Hand service popular but limited scope to expand
Author: Adrian O'Dowd
The digital-first GP service known as GP at Hand has received a mixed review from an independent evaluation report* that found it was highly popular with patients and GPs, but was unlikely to be something that had potential to be rolled out more widely across the UK.
The report used a patient experience survey, qualitative practice-based case studies, economic evaluation, qualitative interviews with wider audiences and an analysis of secondary data to evaluate the service provided by Babylon.
The GP at Hand practice, located in Fulham, London and situated within the Hammersmith and Fulham clinical commissioning group (CCG), provides services to approximately 50,000 patients under the terms of a GMS contract. Patients’ first contact is via an online GP consultation using a mobile phone app or website before further treatment is given in various ways.
Hammersmith and Fulham CCG commissioned Ipsos MORI and the York Economics Health Consortium to carry out an independent evaluation, which was published yesterday.
The report said the majority of GP at Hand patients (85%) had rated their overall experience as “good” and 72% had said the quality of care they received from GP at Hand was better than their previous practice.
However, the report adds that patients who had chosen this model had done so on the basis of access and convenience.
“This evaluation has not concluded that this is the optimal model of care for these patients – just that the high levels of access and convenience offered by this model are highly attractive to this cohort of patients,” it says.
Indeed, since July 2017, 28% of patients who had joined the service had subsequently left, which was a higher departure rate than the London average of one in six.
Babylon GPs were said to be “highly satisfied” working for Babylon and compared it favourably to working elsewhere in terms of flexibility and workload but also having good systems in place to monitor and develop their performance. The service also appeared to reduce use of A&E by its patients.
The authors concluded: “The rapid, unprecedented, and continuing growth of GP at Hand implies there was a latent demand for a service of this kind amongst a segment of the population.
“The GP at Hand service is not currently being used by large numbers of patients with complex needs, potentially linked to the cautionary note about the suitability of the service for some patients, and the current advice that patients should be willing and able to travel to face-to-face appointments. This clearly limits the number and type of patients that are likely to use the service.
“Analysis of the overall efficiency of the service raises significant questions about possible transferability and scalability of the model to other areas and wider groups of patients.”
Babylon welcomed the report and its medical director (UK clinical service) Dr Matthew Noble, said: “This independent report shows that GP at Hand is loved by all types of patients as they can now access a GP when they need to.
“I’m particularly pleased that the report has shown how our GPs enjoy their work, aren’t becoming burned out and how our digital-first approach may even be a way of encouraging GPs to stay in the profession and to help recruit more doctors into general practice.
“The findings show Babylon GP at Hand isn’t just of great benefit to patients and GPs, it is also saving the NHS time and money. When you consider that the average A&E visit costs £160 and the average outpatient appointment £125 then you can see how quickly Babylon GP at Hand and digital-first services can have a positive impact for the NHS.”
The British Medical Association’s GP committee chair Dr Richard Vautrey said: “This long overdue report reflects, and provides clear evidence backing many of the concerns we have been raising for some time about GP at Hand.
“GPs have been at the forefront of digital developments but these are always done with the benefits of all patients in mind, not just a select few. That is why we have consistently expressed genuine reservations about a system that has been rushed-out with little regard for how it impacts patients, practices and the wider healthcare landscape.
“As this report makes clear, this is a service used by predominantly young, healthy and affluent individuals, who appear to be looking for rapid answers to health questions and issues, and are using this service as they would NHS 111, choosing convenience over longer-term quality and continuity of care.”
*Evaluation of Babylon GP at hand: Final evaluation report. Ipsos MORI Social Research Centre & York Economics Health Consortium (May 2019)