Babylon given the green light to expand in Birmingham

Today (20 August) the primary care commissioning committee of Hammersmith and Fulham CCG backed proposals to scrap a restriction limiting the new service’s list size to 2,600.

However, the cap will only be lifted if a ”robust” screening system is in place which ensures patients are offered certain tests, such as cervical smears, in their home city. If the system is not implemented by 15 September then the cap will remain in place. 

The committee also backed proposals that the service’s catchment area should continue to be limited to the boundaries of the Birmingham and Solihull local authority areas.

London-based Babylon GP at Hand expanded its services to Birmingham in June – offering more patients the opportunity to have video consultations via an app.

However, restrictions were placed on the size of its geographical area and the number of patients who would be able to sign up to the service. Babylon was also ordered to set up a ”robust”  screening system within the first three months. 

Babylon GP at Hand has seen its patient list rapidly rise from around 4,000 to more than 50,000 since November 2017. The majority of those patients live outside the Hammersmith and Fulham CCG catchment area.

Hammersmith and Fulham CGG is financially responsible for the entire patient list – including those who are signing up to the service in Birmingham. An internal committee set up by the CCG to scrutinise GP at Hand reviewed the Birmingham service and recommended the cap should be lifted – providing concerns regarding access to local screening services have been addressed.

At the time of the expansion, a spokesman for Babylon said health bosses were working to ensure there were no glitches in the screening system which could mean Birmingham patients are offered tests in London. 

The CCG’s “Babylon GP at Hand Practice clinical and contractual assurance group” said “good progress” has been made on addressing the concerns. 

Work is underway to implement a unique identification code for the new service, known as an organisation data code – which every practice has. This would attach patients to the Birmingham practice when they sign up, providing them access to local pathways and screening services.

When Babylon first announced plans to expand, health bosses raised concerns that patients could be offered services in London, rather than Birmingham, if an ODS code for the Birmingham practice was not implemented.

However, the national primary care support system used to record patient registrations and calls to some screening programmes has not yet been adapted to support the Birmingham ODS code.

If the code is fully implememted by 15 September, then the cap will be lifted. 

A report for the CCG’s primary care commissioning committee said: “The Babylon GP at Hand Practice clinical and contractual assurance group … were assured that through the joint working the majority of links and processes for accessing local care pathways, safeguarding and diagnostics in the Birmingham and Solihull area had been achieved.

“The assurance group recommended that, provided the [primary care support England] system had been configured to use the Birmingham [organisational data service] code, the cap on the number of patients registered from the Birmingham and Solihull local authority area could be removed from 15 September 2019.

“This is in light of the impact on screening call/recall of patients if the Birmingham ODS code is not operational.”

The report added that there are no current plans to extend the clinic’s catchment area beyond the Birmingham City Council or Solihull Metropolitan Borough Council boundaries.

Babylon GP at Hand is a practice based in Fulham, but is effectively run by Babylon Health, as well as GP partners. It offers patients digital primary care services, including video consultations. The move to Birmingham means the London practice is registering patients in another city for the first time. While it has a physical clinic at Badger House, Birmingham, most of the care is delivered digitally.

The expansion of GP at Hand since its launch has had significant financial implications for the CCG and has sparked concerns that it may destabilise the primary care model.