New proposals to control digital GP services like GP at Hand

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NHS England proposes plans to control expansion of digital first healthcare providers
Providers like GP at Hand may need to take on additional contracts and set up new clinics
NHSE director says new plans ensure digital primary care model is “sustainable”

Digital primary care services – like the controversial GP at Hand – are set to be required to establish new GP contracts and clinics in each area they want to be a major provider, under new NHS England rules.

NHSE has launched a consultation on new rules affecting the sector – specifically rules on a practice registering patients outside its immediate area – this afternoon.

GP at Hand has used flexibility in the current rules to register tens of thousands of people with a single west London GP practice it is in partnership with. This is despite these patients living across London and, as of recently, in Birmingham.

In a briefing yesterday, officials indicated that, where a single practice exceeded a given number of registrants in another clinical commissioning group area, it would need to take on a new alternative provider medical services contract. NHSE suggested the creation of this contract would be automatically triggered when the required number of registrants is reached.

The provider would then be required to have a physical premise in that area and join a local primary care network so patients are able to access the full range of services, NHSE said.

NHSE director of primary care strategy and NHS contracts Ed Waller said: “The effect that has is those patients are served by a local contract, held by that local CCG, with that provider.

“This is to get away from the fact that, as the model stands, out of area registration can drive the creation of single practices in one CCG, registering people from across England.

“This is a way of ensuring where that happens in any great number, it creates a separate practice linked back in to local services.”

Babylon Health’s GP service for the NHS, GP at Hand, has been running out of a single practice in Fulham since 2017. It has used a combination of free video GP consultations and the current out-of-area registration policy to register more than 50,000 people – the majority of which are outside Hammersmith and Fulham CCG.

Its growth has had major financial implications for Hammersmith and Fulham CCG. Last week, GP at Hand launched a clinic and service in Birmingham.

Mr Waller said there were currently about 120-125,000 people registered at GP practices outside their home area.

NHSE national director of strategy and innovation Ian Dodge said the proposals “don’t stop people registering” at digital health providers, but ensure “the model is actually sustainable”.