GP at Hand’s primary care network application to be ‘considered’

Hammersmith and Fulham Clinician Commissioning Group (CCG) would “consider” an application from Babylon’s GP at Hand to become its own primary care network.

The move has angered the Londonwide local medical council (LMC), which has escalated concerns over the application to the British Medical Association’s (BMA) GP council.

In May GP at Hand said it was “well placed” to become a primary care network (PCN) with it’s nearly 50,000 registered patients. It has since submitted an application along with GP at Hand partner clinic, Dr Stephen Jefferies.

Hammersmith and Fulham CCG confirmed to Digital Health that, after discussions with NHS North West London and NHS England, it had recommended GP at Hand consider an application to become its own individual network.

“This will enable the CCG to ensure maximal compliance with the PCN criteria, including 100% population coverage, and therefore best meet the needs of  the Hammersmith and Fulham patient population,” a spokeswoman said.

“Should Babylon GP at Hand wish to pursue this option the CCG’s Primary Care Committee will consider the submission as part of the process for agreeing full population coverage by PCNs in the coming weeks.”

It was not clear if the CCG is considering the current application, or recommended a second application without GP at Hand’s partner surgery.

A spokesman for Babylon said GP at Hand was “delighted” it would be considered as a network, calling it a “significant step” towards delivering digital first aims of the NHS Long Term Plan.

A spokesman from the Londonwide LMC said the council was “dismayed” by the decision to consider the application.

The LMC has previously raised concerns about GP at Hand’s application, saying the move would “destabilise” GP services in London “to the point of destruction”.

“We remain of the view that the Babylon GP at Hand position does not meet the nationally negotiated criteria regarding the geographical contiguity of these new networks; a point made in the recently published independent evaluation of Babylon GP at Hand, conducted by Ipsos Mori,” he said.

“As the contract and PCN criteria were negotiated at a national level between NHS England and GPC, this matter has been formally escalated to GPC for further action.

“We look to NHS England and GPC to consider how such an out of specification application should be dealt with. In particular, this must be done with no detriment to practices, and their patients, who most definitely do meet the nationally negotiated criteria.”

Primary care networks, outlined as an essential building block of Integrated Care Systems (ICS) in the NHS Long Term Plan, are a group of general practices’ working together to offer more personalised, coordinated care for registered patients.

Under the new GP contract,  which came into effect on 1 April, PCNs must exist within connecting boundaries, within the same clinical commissioning group (CCG) area and serve populations not exceeding 50,000 – a number Babylon is fast approaching.

PCNs are guaranteed an estimated 20,000 additional staff across the board – including clinical pharmacists, physician associates, physiotherapists and community paramedics – by 2023/24, with the CCG responsible for the PCN receiving a recurrent 70% reimbursement from NHS England.

That will amount to £891 million of new annual investment by 2023/24.

But that’s based on PCNs being set over clear geographical areas. Babylon, while being funded by Hammersmith and Fulham CCG, has patients registered in a number of different boroughs that aren’t easily linked.

A little as 5% of its registered patients live in Hammersmith and Fulham, according to a spokeswoman.

GP at Hand was recently been given the go ahead to expand to Birmingham – adding further concern than additional staff won’t benefit all patients.

The MP for Hammersmith, Andy Slaughter, has called on the Health and Social Care Committee to carry out an inquest into GP at Hand, raising concerns that funding the app has created a deficit of “at least £26million for the period of 2018-2020 which is currently being borne by H&F CCG”.

The BMA GP Council was contacted for comment.

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