Comment: Over 25% of patients leave GPs at the hand of a digital service

Article written by Medical Negligence Solicitor and Team Leader, Darren Tamplin-Compton

After recently highlighting concerns in delays to reporting by the health regulator, the Care Quality Commission (CQC), upon GP at Hand’s controversial video consultation service, GPOnline now reports that more than one in four NHS patients who registered with Babylon GP at Hand, left the video consultation service within a little over a year. 

Between November 2017 and January 2019 a total of 55,556 patients joined the digital provider of GP services, according to figures obtained by GPonline under the Freedom of Information Act. 

Over the same period, 15,623 patients deregistered from the service; more than one in four of the total number who signed up. 

GP at Hand’s website explains that it is “An NHS GP practice that works around you” and that “GPs are available 24 hours a day, 365 days a year. Every session is free, no matter how long the appointment lasts. We offer a full NHS GP service including digital appointments, physical appointments at one of our five locations, repeat prescriptions and specialist referrals. By registering, you will be switching from your current NHS practice to GP at hand… Babylon GP at hand is available to everyone who lives or works within 40 minutes of our five London clinics.” 

According to GPOnline, the rapid turnover of patients was ‘concerning’ since such behaviour would leave the NHS facing significant increased costs. Finance papers published earlier this month by Hammersmith and Fulham CCG revealed that a £10 million hole in its finances, triggered by GP at Hand could threaten other services in the area.

GP at Hand (which is hosted by a West London GP practice) admitted that the figures reflected the likelihood that many of the people signing up for the service were unaware that doing so meant that they would be deregistered from their existing physical GP surgery. 

November 2017 is the point that the digital provider began to grow its patient list exponentially using out-of-area patient registration rules to entice patients living and working across a wide area in and around London. 

The latest official figures show that Babylon GP at Hand now has over 46,000 patients in total; almost 10 times the number in November 2017.  More than half of patients registered with the service are aged 20 to 29 and 85% are aged 20 to 39.  This has led to accusations of ‘cherry picking’, the younger and generally healthier / cheaper demographic of patients; which GP at Hand denies. 

Chair of the BMA GP committee, Dr Richard Vautrey, said: “This extremely rapid turnover is concerning but not in the least surprising.  People are obviously predominantly using this service as they would NHS 111, for immediate and short-term care rather than long-term continuity of care… Not surprisingly patients won’t understand the NHS funding consequences of this pattern of behaviour, with the significant increased costs to the NHS compared with routine GP services. To provide this to all patients would rapidly bankrupt the NHS which is why urgent steps need to be taken to reform the out-of-area registration arrangements, something I’ll be calling again for in my LMC [Local Medical Committees] conference speech.”

A spokesperson for Babylon GP at Hand told GPonline: “We now see far fewer people de-registering from Babylon GP at Hand.  We believe the figures you cite are a legacy from the launch of Babylon GP at Hand when many people did not realise they would have to de-register from their existing practice… We greatly improved how clear we are regarding registration and new users are fully aware that, just as with anyone joining any new NHS GP practice, they must de-register from their existing practice first as they can only be registered with one.’

Darren Tamplin-Compton, Senior Solicitor and Team Leader within Fletcher’s Medical Negligence Team, who lives in rural Suffolk, said: “Whilst the perceived economies of scale and the potential financial attractiveness to GPs of delivering predominantly digital or telephone services to the relatively well and young, seem obvious, it is clear that the service has not suited all participants and has raised the spectre of significant financial ramifications for the local CCG in which this operator is sited. 

“Whilst Babylon GP at Hand should probably be commended for its innovative approach, personally, I would rather see existing, forward thinking GP surgeries stepping up to routinely offer video-conferencing to those patients that are comfortable using that technology, rather than huge, out of community based or led, conglomerates stealing a march on traditional GP practices. It will be interesting to both see Dr Vautrey’s address to the Local Medical Committees conference in Belfast, today, calling for changes to the GP contract to ‘limit abuse of the out of area regulations’ and to gauge the response of the conference.