• CQC gives Babylon’s NHS digital service GP at Hand “good” rating
  • But rated “requires improvement” for effectiveness
  • Inspectors note service failed to meet cervical screening and childhood immunisation targets
  • A favourable CQC report into Babylon’s private service also published

The Care Quality Commission has rated GP at Hand “good” in the first inspection of its digital healthcare service. 

Inspectors also gave the service a “good” rating in four out of its five domains, although the service was rated “requires improvement” for effectiveness.

GP at Hand is the GP practice run by the company Babylon Health, along with GP partners, whose patients primarily access it digitally using video and text. The service has been highly controversial, with some GPs and others expressing concerns about standards.

Babylon Health provides a private video consultation service but also has several NHS contracts, including with GP at Hand.

Inspectors on GP at Hand cited failure to hit targets for cervical screening and children’s immunisation and limited instances of quality improvement activities which showed results for patients as the reasons for the effectiveness rating.

The service was rated “good” across most of the population groups the CQC reports on, but it received a “requires improvement” for working-age people, and for families, children and young people. 

This was partly down to the failure to meet World Health Organisation’s childhood immunisation targets of 90 per cent. There were also “considerable delays” for travel vaccination appointments of around four weeks at the time of inspection, the CQC found, but its report said plans had been put in place to address both issues.

The CQC did not find GP at Hand to be in breach of any regulations but did make a number of recommendations. These included: improving the quality of clinical assessment record keeping for face-to-face consultations; introducing a system to make sure patients with particularly worrying symptoms were followed up and reviewing staffing numbers to better meet the increasing demand for services such as cervical screening and childhood immunisations. 

The third CQC report into Babylon’s private digital health service was also published today, which found it was providing a safe service in all areas. This was an improvement on its last CQC inspection in 2017, which found not safe in “some areas”. At the time, Babylon took CQC to court in unsucessful attempt to block publication of that report.

Matt Noble, lead GP at Babylon Health, which runs the GP at Hand practice, told HSJ he was “pleased” with the ”good” rating, stating: “I would love our next GP at Hand inspection to be outstanding.

“Given the three things they picked up on this time, which was the child immunisations, which we have got a strong plan for, travel, which will be pretty much sorted in the next couple of weeks and smears and screening, we are already well above the local average and are heading towards the national average and beyond.

“We can remove those concerns around requires improvement very very quickly, if not already.”

In particular, Dr Noble pointed out the low cervical screening uptake figure - 50.3 per cent compared with the national average of 71.7 per cent - was now a year out of date.

As of today, cervical smear uptake at the practice is 66.9 per cent – which Dr Noble said was improved by reaching out to patients on Instagram, rather than just through letters and text messages.

He added there are similar plans in place to improve uptake of childhood immunisations.

GP at Hand – which is based in Hammersmith and Fulham’s Clinical Commissioning Group’s area – has attracted thousands of registrants from outside its immediate area, and has five clinics around London.

Since November 2017, the patient list has grown from about 4,000 to around 50,000.

Some GPs and others have accused it of benefitting from a patient list which they say is healthier than average, and of destabilising the NHS primary care model, while its expansion has also caused financial problems for the CCG. 

But the CQC recognised the practice for “delivering a new innovative model of primary care working”.

The CQC report stated: “Evidence showed that the practice proactively sought ways to improve. All staff were involved in developing the services offered and were encouraged to identify opportunities to improve the service delivered.

“Systems were in place to continuously gather feedback from patients and the information was used to improve the service.

“The practice was focused on delivering a new innovative model of primary care working by providing a ’digital first’ service whilst maintaining the standards of a traditional NHS GP practice.”

In February the CQC changed its policy to enable the inspection of how health services use digital tools. The previous inspection of GP at Hand took place in 2017 and did not consider its digital services.

In 2017 Babylon Healthcare sought to block and amend a CQC inspection report which found its private digital primary care service - which is registered and inspected separately from GP at Hand - was “not safe” in some areas, including seeking a judicial review.

This story was updated on 22 May to reflect the publication of the CQC report into Babylon Healthcare, and points made by the CQC and Babylon.