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Sunday 16 June 2019
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Global sum 'may not work well' for GP at Hand model, finds official evaluation

The long-awaited official evaluation of Babylon’s GP at Hand model has concluded that policy makers should consider a different funding model for online GP service providers.

The long-awaited official evaluation of Babylon’s GP at Hand model has concluded that policy makers should consider a different funding model for online GP service providers.
 
The report, written by Ipsos Mori and published today on the NHS Hammersmith and Fulham CCG website, found that satisfaction with the service was high, but found ’the service is not being used by large numbers of older people, or people with more complex health needs’.
 
It said that there was a potential impact on neighbouring practices, who would be left with more complex patients, adding that there were 'costs attached to dealing with patients with complex needs that [Babylon] are not incurring’.
 
The report also found:

  • The success of the GP at Hand model 'implies there is a latent demand for a service of this kind amongst a segment of the population’;
  • Satisfaction was high for most patients, but mainly due to the increased access;
  • Patients may be less likely to attend for screening appointments;
  • GPs who worked at Babylon ‘appear very satisfied’, and suggested it ’may be useful to consider if and how these features can be replicated more widely in conventional general practice’;
  • However, there are implications around GPs living outside of the communities for whom they are providing care;
  • GP at Hand experiences higher rates of deregistering that the rest of London, with patients who deregister typically leaving after two weeks.

 
BMA GP committee chair Dr Richard Vautrey said: 'As this report makes clear, this is a service used by predominantly young, healthy and affluent individuals, who appear to be looking for rapid answers to health questions and issues, and are using this service as they would NHS 111, choosing convenience over longer-term quality and continuity of care.
 
'Indeed the rapidity with which large numbers of patients deregister and only to re-register with their previous practice provides evidence for this.'
 
The report concluded: ’The evidence available suggests that the Global Sum Allocation Formula may not work well in establishing the costs of providing GP services for patients who choose to be treated through a digital-first service and, therefore, in providing appropriate funding levels.
 
'The evaluation has shown that GP at Hand patients have better health than comparable patients using traditional primary care but that they are higher users of primary care.’
 
It later added: 'Policy makers will also need to consider the appropriateness of the current funding formula for a digital-first service.
 
'The current funding formula is based on a number of factors including population demographic and illness profiles, but it does not take into account demand for services.
 
'The evaluation has shown that BGPaH patients have better health than comparable patients using traditional primary care but that they are higher users of primary care.
 
‘Further research would be required to understand whether the higher use of primary care services was a product of specific health concerns or simply due to better accessibility.’
 
Dr Matthew Noble, medical director (UK Clinical Service), Babylon, said: 'This independent report shows that GP at Hand is loved by all types of patients as they can now access a GP when they need to.
 
'I’m particularly pleased that the report has shown how our GPs enjoy their work, aren’t becoming burned out and how our digital-first approach may even be a way of encouraging GPs to stay in the profession and to help recruit more doctors into general practice.'
 
Dr Noble added: 'The findings show Babylon GP at Hand isn’t just of great benefit to patients and GPs, it is also saving the NHS time and money.
 
'When you consider that the average A&E visit costs £160 and the average outpatient appointment £1252 then you can see how quickly Babylon GP at Hand and digital-first services can have a positive impact for the NHS.’
 
A version of this article was first published by our sister publication Pulse.