Union asks Hunt to scrap new 'GP at Hand' NHS service

A number of GPs are reportedly in “revolt” over what they say is a serious financial threat from a new online service, which offers remote consultation by telephone and video chat to NHS patients.

Unite the Union, which represents doctors under its Medical Practitioners’ Union branch, says the ‘GP at Hand’ service is draining funding from surgeries “for patients with the most complex needs”, calling for the scheme to be axed.

In a statement, the union asked health and social care secretary Jeremy Hunt to scrap the model of care used by the GP at Hand service, which it said threatened “the very survival” of NHS general practice in its current form.

GP at Hand is operated as a general practice under the Hammersmith & Fulham Clinical Commissioning Group, offering GP services to patients in a number of London postcodes.

It is operated by technology-focussed health service provider Babylon Health, and touts the service’s benefits as offering remote consultations 24 hours a day.

It also suggests patients are able to access face-to-face consultations easier, with most patients seen to remotely removing the traditional telephone queue for appointments at opening time.

The crux of the problem, according to Unite, is that when patients register with GP at Hand, it becomes their general practice and funding is removed from their old, local practice.

It said it was concerned that GP at Hand now wanted to expand across England.

In a letter to Jeremy Hunt, signed by more than 130 “health professionals”, Unite said that since the service launched in November last year, around 26,000 patients had registered with GP at Hand - most of them being between the ages of 20 and 39.

Unite did not confirm how many of the signatories were currently working in general practice, but suggested “many of them” did.

In the letter, it said practices had seen their list sizes fall for the first time in years, due to patients registering with GP at Hand.

“There is no doubt that GP at Hand will destabilise other practices, robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients.

“Losing registration fees for younger, fitter patients who join GP at Hand threatens the model of general practice relied on by so many patients.”

Unite said the scheme was “hoovering up” younger, healthier patients and restricting access to those who were pregnant, frail, terminally ill or suffering from multiple health problems.

The British Medical Association had previously voiced concern that GP at Hand was not open to taking on patients with existing long-term illness or who were pregnant, with the service claiming the limitations of remote consultations were not necessarily appropriate for such patients.

“Continuity of care is threatened because you may never see the same GP again when consulting GP at Hand,” the union continued.

It said that in practice, 70% of all patients are reasonably well, with their funding helping surgeries care for the 30% who are sick.

“It’s a system that works, because it’s fair,” it wrote, adding that “we all eventually end up in the 30%.”