This story was first published in digitalhealth.net

Martin Rowland has warned that the expansion of the NHS GP at Hand service risks ‘destabilising care’ for the most complex and vulnerable cases.
Rowland, who is emeritus professor of health services research at the University of Cambridge, said that the virtual GP service, where patients are consulted over smartphones, would ‘cream off’ fit young patients from existing practices at the expense of those with the greatest needs if rolled out across the country.
At present, millions of NHS patients in London and Birmingham can sign up to the service, which offers a GP consultation via a smartphone 24 hours a day. The app offers a symptom check for patients and video GP consultations within hours. More than 50,000 people have enrolled at the service, created by private health provider Babylon.
However, the technology has faced criticism for ‘cherry-picking’ healthy patients. Rowland, who was a GP for 35 years, told PA the practice was meeting the needs of a particular group of people ‘but not addressing the wider needs of the population’.
He said: “It’s essentially taking money away from practices. This hasn’t happened to a great degree because clearly GP at Hand has only taken a small number of patients from any one practice, but if you are making the situation where, in a hypothetical example, GP at Hand took away all the patients away from the practice and left the practice just with the chronically ill and elderly, and the funding didn’t reflect that, then essentially those GPs would have even less money to look after those older people.
“However, the current NHS funding formula does not adjust adequately for the costs of providing a comprehensive primary care service, and the NHS needs urgently to review its arrangements that have allowed a private company to cream off fit young patients from existing NHS practices. If the GP at Hand model became widespread, it would risk destabilising care for patients with the greatest needs and those who need regular proactive care.”
This story was first published in digitalhealth.net
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