The must-read stories and debate in health policy and leadership.

Digital provider Babylon Health’s CEO told investors last week it is going to be “very cautious” about any further growth of its GP services in the UK.

Speaking about plans to expand on GP services, Ali Parsa said Babylon, which provides private digital-first primary care services, was “overwhelmed” with demand for its GP services and because of “structural challenges” it faces, it loses money on “every [patient]” it treats.

He added: “As a result of that we need to be, in today’s environment, super careful about the speed at which we grow that book. So we’re going to be cautious about the growth of that book, being very frank about that.”

His comments come after the firm’s share price plummeted to $1 from around $10 when it went public last autumn.

Asked about the share price, Mr Parsa said the timing of the company’s stock market listing last October was a significant factor, as there was subsequently a major withdrawal of institutional investors from technology and growth stocks across the whole market. He added: “We’re fully aware of this situation, we are all over it and we will fix it…”

Babylon has done well to attract tech-savvy patients and provide healthcare at subsidised rates. But, as one of the commenters on the story suggests, it does not come as a huge surprise that being able to access GP services on demand through an app has resulted in higher numbers of patients using the service and, hence, has become less profitable given the reimbursement it receives from the government.

Taking stock

What skills can we identify in NHS England chief executive Amanda Pritchard, 10 months into the job? That is the question with which our editor Alastair McLellan kicks off his latest editorial.

He observes that the first NHSE CEO, Sir David Nicholson, was famously the master of “grip” and had an unequalled feel for the task of NHS leadership, and that Lord Stevens possessed a genius for intellectual challenge and political influence.

So what does Ms Pritchard bring, he asks.

One characteristic is her respect for local NHS leadership, “marking a clear break with the sometimes fractious Stevens era”, writes Alastair.

He also notes that this collegiate approach extends to how she runs the NHSE top team. Whereas Lord Stevens was the ultimate decision-maker on a bewilderingly wide range of topics, there is now a much more even spread of workload between Ms Pritchard, finance director Julian Kelly and chief operating officer Sir David Sloman.

“Ms Prichard is also appreciated for the quiet courage she is bringing to her task. It is just as well she is of stout heart, because the breadth of problems facing the service is greater than those ever faced – even in the pandemic – which has, of course, added to the strain.”

Unlike Lord Stevens, however, Ms Pritchard does not appear to enjoy speaking out in defence of the service, writes our editor.

“To NHS staff, the constant attacks on the service must feel like a knife twisting in a wound.

“It is here the NHS misses Lord Stevens most. HSJ is confident he would not let these misunderstandings and misdirections stand.

“Ms Pritchard might not relish the opportunity as much as her predecessor, but she is perfectly capable of taking on this narrative – and should do.” Read the full editorial here.

Also on today

Potential pay disputes, ambulance service meltdowns and a spot of helpful animation all make it into this week’s The Primer, our NHS version of Brodie’s Notes, and in comment, Louise Ansari calls for better support for GPs in recognising and managing long covid.