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‘Grossly underfunded’ practices unable to compete with online providers, warn GPs

by Nicola Merrifield
30 August 2018

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Private online providers are creating competition between NHS practices that is threatening the loss of both patients and staff and could lead to practice closures, GPs have warned.
The companies are setting up services at a time when NHS practices are so underfunded they are struggling to offer basic GMS care, let alone develop technology for online consultations, suggested the GPs.
Anxieties are also growing among practices because they are unable to compete with the ‘aggressive’ advertising used by private providers, they added.
The GP concerns were raised during a Pulse investigation looking at the extent to which private digital firms pose a threat to traditional bricks-and-mortar NHS practices.
Figures from the CQC show there are now 37 private providers registered in England to carry out online consultations.
In Wales, regulators have received five enquiries in the past year from online GP providers wanting to register, and Scotland is currently in the process of registering its first two online primary care providers.
These companies include online video consultation providers such as Babylon, which has also formed a partnership with an GMS practice in London to offer its GP at Hand service to NHS patients, and Now Healthcare Group, which offers online consultations to private patients – but is due to start offering its technology to NHS practices for free.
Other providers are also looking to target NHS practices by forming partnerships.
Push Doctor – a private service that currently offers video consultations with GPs ‘in minutes’ for £20 each – is in talks with Birmingham-based superpractice Modality about offering its service to patients for free in order to attract NHS patients.
Meanwhile online triage and consultation tool eConsult is being rolled out in numerous practices across the country after it was trialled in the capital. The Hurley Group, which developed the tool, has said its own NHS superpractice in London plans to see patients face to face only when necessary in the future.
East London GP and deputy chair of Doctors in Unite Dr Jackie Applebee said the trend towards online services has serious ramifications for general practice.
She said: ‘There will be an increase in patients moving around… There is cherry-picking of younger, fitter patients – on whom we rely. Some practices could go under, because they are losing these patients.’
At the same time, the number of GPs working for online providers has been increasing and this means staff are being lured away from other practices, according to Dr Applebee.
‘There’s no two ways about it – if GPs are not working in traditional general practice and are working for an online provider, that is creaming off staff,’ she said.
Dr David Mummery, joint chair of Hammersmith and Fulham LMC, the area of London where GP at Hand is hosted by Dr Jefferies and Partners, suggested neighbouring practices were unprepared for the number of patients registering with the service.
He said: ‘There wasn’t much of a warning. GP at Hand was a bit of a bolt from the blue. It was full-on and quite aggressive advertising. Posters when you got off the tube at West Brompton, things on the underground. It was clever marketing.
‘It created a lot of anxiety for GPs as to whether all their healthy patients would be attracted to GP at Hand.’
Babylon’s medical director Dr Mobasher Butt said competition already existed between practices and that they were able to offer their own online services.
He said: ‘It’s an even playing field. Any practice is able to think of innovative ways to provide care and there’s nothing about the launch of GP at Hand that precludes anyone else from forming similar innovative solutions.’
But BMA deputy chair Dr David Wrigley said practices were so under-resourced they were struggling to even provide core services.
He said: ‘Most practices struggle to offer basic GMS care at the moment due to gross underfunding and lack of staff, so it is unfair that companies who seek funding from city financiers set up services to compete with surgeries. That’s not a level playing field.’
This article was first published on our sister publication Pulse