HSJ’s round-up of Tuesday’s must read stories and debate

Babylon system

A London clinical commissioning group has gone cap in hand to NHS England, after estimating that a new “digital first” GP practice on its patch could cost upwards of £10m next year.

GP at Hand, a partnership between Babylon Health and a single Fulham practice, is trying to shake up NHS primary care with a business model based around attracting NHS patients with the promise of video consultations on their smart phone.

So far, it seems to be working.

The practice’s patient list has grown fivefold in less than six months, three quarters of them from outside its base in north west London (and some from outside the capital entirely).

GP at Hand has five physical premises throughout the city (and would have more if it could) but, for commissioning purposes, the practice is still based in Fulham.

That means GP at Hand’s 25,000 patients (and counting) are Hammersmith and Fulham CCG’s financial responsibility. Hence the appeal to NHS England.

If GP at Hand’s current model continues to expand beyond London (new premises have been mooted for Manchester and Birmingham), the CCG could conceivably end up footing the bill from millions of patients from Hadrian’s Wall to the English Channel.

It is, however, presumably not going to come to that.

Babylon could instead go for a model in which it partners with a different “GP at Hand” practice in each region – rather than running everything through London.

NHS England could potentially step in, more forcibly than it has already, if GP at Hand proves too disruptive, either slowing growth or fiddling with the payment model to distribute the costs more evenly.

Competitors, both NHS and non-NHS, with different business models could catch up, or surpass, GP at Hand.

Regardless, the disruption already caused is a reminder that technological innovation is just as likely to come from left field as from the centre.

If it can’t control technological disruption in the NHS, the centre needs to be ready to react quickly and adapt these innovations to meet the needs of the system – and patients.

Sometimes that will mean adapting the system to fit the innovations.