Does Babylon GP at Hand reveal the future of general practice?

Problem

Babylon GP at hand provides a digital first service in London based on offering video-consultations by smartphone within 2 hours, 24 hours a day. Patients can then be seen face-to-face if necessary. The service is free on the NHS via an NHS general practice subcontracting services to Babylon Health, a private company also providing similar services privately. It has grown very rapidly in London and is soon expanding to other cities. GP at hand has proved highly controversial, amid claims that it ‘cream-skims’ young healthy patients and will destabilise conventional general practice. This presentation will summarise the first evaluation of this new service.

Approach

This evaluation was commissioned from IPSOS Mori advised by Prof Chris Salisbury, and explored the impact of Babylon GP at hand on its registered patients, its GP workforce and the wider health care system. The evaluation was based on (i) anonymised data from GP at hand about patients’ characteristics and consultations (ii) an online survey of GP at hand patients to assess their experience, compared with a matched cohort of patients with similar characteristics responding to the GP Patient Survey. (iii) in-depth interviews with GPs and patients (iv) routine data about use of other NHS services (v) qualitative interviews with stakeholders about future developments in primary care.

Findings

Details of findings are strictly embargoed until the evaluation report is presented to the CCG in mid-May. This resentation will provide data on:

* How many people register with GP at hand and how many de-register again soon afterwards

* The age, sex, deprivation and levels of chronic illness in registered patients

* Their rates of different types of consultation and rates of prescribing antibiotics

* Use of 111, A&E, outpatients and hospital admissions before and after registering with GP at hand, compared with matched controls

* Reasons that patients register with GP at hand, their satisfaction with different aspects of the service compared with similar patients in other practices

* Characteristics of GPs working at GP at hand and why they chose to work there

Consequences

GP at hand represents a ‘disruptive innovation’ which could have major implications for the future of general practice. The findings of this early evaluation raise important questions about the type of care that is preferred by some segments of the population; the impact of this on the wider NHS; the implementation of digital and video consultations; the sustainability of this model of care and implications for the sustainability of other practices; and the attractiveness of a GP career. The findings and the debate about ‘cream-skimming’ also have important implications for how to ensure that the GP funding model is appropriate for new models of GP provision.