Slick firms offering GP appointments by app are ‘luring doctors away’

Traditional GP surgeries are facing an unprecedented threat from the rise of firms providing online appointments on smartphones, a doctors’ leader warns today,

The private companies offering these consultations are ‘luring’ away both medical staff and patients, warns the head of the Royal College of GPs.

Professor Helen Stokes-Lampard says doctors are quitting already understaffed surgeries to work from home for much higher salaries.

She said of the online firms: ‘They can afford to pay above the market rates, they’re looking after their staff really well and so [doctors] are saying… I’m going to resign from my already hard-pressed general practice to go and work for them.’

Traditional GP surgeries are facing an unprecedented threat from the rise of firms providing online appointments on smartphones, a doctors’ leader warns today

GP practices are left underfunded and at risk of closure when patients decide to move to a firm that provides online appointments round the clock. 

This is because surgeries receive a set amount from the Government based on the number of patients on their books.

The professor said she was ‘anxious’ that online consultations were being rolled out without being rigorously tested.

Earlier this year, Britain’s care watchdog, the Care Quality Commission, warned that four in ten online GP and pharmacy firms were unsafe, with many found to be handing out addictive painkillers and antibiotics too freely.

Professor Stokes-Lampard is so concerned for the future of traditional surgeries that she has written to Health Secretary Matt Hancock.

Mr Hancock has heavily endorsed the country’s largest online firm, Babylon Health, and in particular its GP At Hand app – which he uses.

But Professor Stokes-Lampard’s letter warns that this model ‘risks financially destabilising general practice’ and could force many surgeries to ‘close their doors’.

She also points out that it would create a ‘two-tier’ system in which healthy patients could see a GP quickly online, whereas the sick and elderly would wait for a face-to-face appointment.

‘We have serious concerns about the unintended impact on wider primary care,’ her letter concludes.

GP surgeries are already in crisis due to a shortage of GPs, combined with the growing pressures of the ageing population. An average of one in seven GP posts is unfilled.

Professor Stokes-Lampard said many were leaving to work for Babylon and other firms where they could earn up to £120,000 a year. Others had cut down on their surgery hours to do a few sessions for these private firms a week, working from home, she said.

‘It’s the higher salaries, the ability to work from home and that they look after people, in terms of the training and perks and benefits. They’re paying above what the NHS pays.’

Babylon Health offers patients ten-minute consultations – via smartphones or computers – for £25 a time. It provides these appointments free to patients who live or work in London if they de-register from their existing GP surgery and sign up with its practice in west London.

A total of 32,000 patients have joined since its launch in November, including Mr Hancock, who described the service as ‘revolutionary’.

The firm is planning to expand to Birmingham and Manchester over the next few months.

A current job listing offers GPs a salary of £100,000 a year to work from home or £120,000 a year if they are based in the west London practice or one of four other London hubs.

It promises doctors ‘no home visits ever’, ‘no paperwork’ and ‘no never-ending duty days’. This is where GPs have to remain on surgery premises to see emergency patients.

Professor Stokes-Lampard is also concerned that the safety of online consultations has not been properly tested in a clinical trial – like a new drug.

She will challenge Mr Hancock’s endorsement of Babylon at a fringe event at the Conservative Party Conference in Birmingham next Monday.

A Babylon spokesman said: ‘The Royal College is absolutely right to highlight that practices all too often do not have enough GPs. Technology is the solution, not the problem.’ 

Q&A on smartphone consultations

What are smartphone consultations?

Over the past five years there has been a surge in private firms offering virtual GP consultations, via smartphones or computers. They are carried out by NHS and private GPs and usually last ten minutes for up to £25. Most offer appointments seven days a week, 24 hours a day, with just two hours’ notice.

The largest is Babylon Health, which offers free consultations for London patients who must leave existing surgeries and join its practice in Fulham, west London.

Who is allowed to sign up?

Anyone can pay for a private consultation with Babylon or any other of the firms. But certain patients are strongly discouraged from registering with Babylon’s free GP At Hand service, including those with complex illnesses.

Why might surgeries close?

Surgeries receive an average of £150 from the Department of Health for every patient on their lists. If patients leave their existing surgery to join Babylon, then the practice lose money.

So far 32,000 have left their surgery to sign up to Babylon since it launched the GP at Hand smartphone consultations in November.

The consultations are currently only offered to patients who live or work in London. But Babylon is hoping to open hubs in Birmingham and Manchester over the next few months and afterwards expand nationwide.

Why are they a problem for the sick and elderly?

Babylon won’t allow certain groups to sign up for online consultations including pregnant women, the frail and patients with dementia. They are costly for surgeries, unlike healthier patients who rarely see a GP and are profitable – who are being encouraged to switch to Babylon. This could leave surgeries even more financially unstable as they are left with expensive patients.

Are these consultations safe?

The consultations are carried out by qualified GPs, many of whom work for NHS surgeries. But senior doctors say they could never replace in the flesh appointments, particularly with patients they know. GPs might miss subtle warning signs such as changes in the way a patient walks into the room, the colour of their face or their weight.

They are also worried the online consultations will undermine the doctor-patient relationships. Patients may be less willing to talk about embarrassing or worrying symptoms during a smartphone consultation with a doctor they have never met.

 

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