The London host CCG of GP at Hand has decided to maintain its position to block the service’s expansion to Birmingham.
The decision, taken at a meeting of the NHS Hammersmith and Fulham primary care committee yesterday, was taken in response to NHS England concern about patients’ access to health screening.
Babylon, the private company behind the NHS app, had applied to launch a physical branch to see patients in the UK’s second-largest city but the plans were blocked by CCGs due to patient safety concerns relating to local infrastructure.
A GP at Hand spokesperson said NHS commissioners had been given plenty of pre-warning of its expansion and should have put necessary plans into action for the sake of patients.
Babylon offers its NHS app to patients across London via a host GMS practice in Fulham in south-west London since November last year. Via the app, patients are offered a same-day video consultation or a next-day GP appointment at one of five London hubs.
Under the plans, the service would continue to be offered via the London NHS GP practice, under the out-of-area registration scheme, but the added physical location in Birmingham would mean patients from that region could also sign up to the app.
But, as our sister publication Pulse – where this story was first published – reported last month, concerns about patient safety related to the expansion were voiced by both NHS Hammersmith and Fulham CCG, from which GP at Hand operates, and NHS Birmingham and Solihull CCG.
NHS Hammersmith and Fulham board papers, published ahead of yesterday’s meeting said the NHS England (London) medical directorate had advised it to uphold its position to block the expansion due to concerns with patients accessing necessary health screening.
The papers said: ‘[T]here continue to be outstanding concerns regarding access to clinical pathways and arrangements for GPAH patients accessing screening services…Access to local clinical pathways could be addressed as part of the mobilisation and prior to registering any patients in Birmingham.
‘However, the concerns regarding patients accessing screening services and related follow up services is more complex to resolve at a local level and currently there is not a satisfactory or sustainable solution to ensure that patients will be able to participate in screening easily.’
The papers also said that despite the CCG having full delegated commissioning responsibility for general practice, the matter of the expansion was of significant enough importance to request that NHS England make the final decision. Therefore, the decision reached by the CCG is being ‘referred to NHS England for approval’.
In a statement following yesterday’s meeting, the CCG said: ‘The clinical advice received from NHS England (London) medical directorate is that whilst further assurance has been received on the areas outlined in the July committee meeting, there continue to be outstanding concerns regarding access to clinical pathways and arrangements for GP at hand patients accessing screening services.
‘It is therefore not reasonable to lift the objection until a safe and sustainable solution is in place. The committee was concerned, for example, that arrangements for national screening services, such as mammograms, can only currently be accessed via the patient’s GP referring them to local services.
‘So potentially patients in Birmingham may not be able to access screening services local to them.
‘Similarly, the committee wanted clarity on how referrals to local services in Birmingham, such as community mental health services, would work in practice. For these reasons, the committee’s objection remains in place at this stage.’
A GP at Hand spokesperson said: ‘Commissioners have known for more than nine months of the proposed national expansion of GP at Hand. The NHS has not been able to put in place the screening arrangements that enable this.
‘As a result, the choice of GP practice promised by the NHS to people across the country is being held back and the opportunity to reduce pressure on primary care and A&Es is being missed. We hope this issue will be resolved without further delay so that safe, effective and extremely convenient primary care can become a reality for anyone who chooses it.
‘The CCG made it clear at today’s meeting that GP at Hand has done everything required of it in planning the expansion to Birmingham. We will continue to work with commissioners and screening leads to bring GP at hand to people across the country.’
Last month, Pulse revealed that Babylon had started recruiting GPs for its Birmingham expansion despite the current block by commissioners. At the time, Babylon said its intentions to expand to Birmingham remained and were subject to the consideration of commissioners.
It has already signed up over 30,000 NHS patients from the wider London area.
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