GP at Hand promises a service that allows people working or living in a broad area of London to get a digital consultation with an NHS GP within a couple of hours of their request. They just need to quit their existing GP practice and register as an out-of-area patient.
However, GP at Hand say their service is not appropriate for those with complex physical or mental health problems, pregnant women, or people with learning difficulties, drug dependence, those who are frail, have social needs, or dementia, need end of life care, or have a safeguarding need. So by and large, they focus on healthy young people – who happen to be the most profitable patients!
Most GP practices get the same amount of money per year, per patient, irrespective of their patients’ needs. About 80% of patients will be reasonably well and because they need less care, their funding helps to pay for the 20% who are sick. But when a GP practice focuses on those who are well, they increase their own income while taking patients – and therefore NHS funding – from GP surgeries that continue to take care of those who are sick or have complex needs, and may now have a disproportionate number of these patients.
GP at Hand can provide some face to face consultations at 6 sites across London. But all patients register with a particular practice in north west London. As a result, their GP list size has increased from 2,500 in April 2017 to 24,652 by 1st March 2018. 75% of these new patients live outside the area. The local Clinical Commissioning Group (CCG) does not get any extra funding for this out of area population and calculates that it could be facing extra costs of £10.6 million by the end of the current financial year, pushing it into deficit.