Digital-first update – October 2019

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At the end of September NHS England’s board agreed proposals put forward following its most recent digital-first consultation.

The NHS England board paper on digital-first recommendations can be viewed here. The main issues decided on where:

  • Out-of-area registrations will be allowed to continue, with out-of-area patients funded at the same level as those living within practice boundaries.
  • The new patient registration premium remains unchanged.
  • Once a digital-first practice has over 1,000 patients registered within a CCG area, these patients will be ‘desegregated’ into a new list as part of a new APMS contract, with the requirement that the provider offer appointments from a premises inside the CCG area.
  • Details of how this process will work have yet to be published and it will require changes to GMS regulations to be approved by the DHSC.

Londonwide LMCs’ response

Dr Michelle Drage, our Chief Executive, issued the following statement about the agreed changes, which was covered by Pulse:

“Areas that are under-doctored may (and probably do) have patients with a high level of complex need, patients who may struggle to use a digital first model, issues regarding IT literacy, and infrastructure and access challenges which add to health inequalities. Digital services should be developed in an integrated way, alongside other services within existing practices so that they are there to be used if required. Evidence shows that primary care is best delivered by expert generalists working with registered lists in defined geographic communities. The core funding that allows and supports this care delivery at individual and population level must be maintained and, where possible, increased.

“In order for investment in digital health tools to fit with the values of general practice, such tools must directly reduce health inequalities, or free up resource which can be directed to other methods of care delivery which are proven to do so. It is critical that more focus is placed on understanding the high turnover rate for patients registered with digital first providers; a point made in the recently published ‘independent evaluation’ of Babylon GP at Hand, conducted by Ipsos Mori.

“For the potential of digital health to be realised, all practices need the infrastructure to provide it, the knowledge to use it effectively, and the patient demand to justify the investment of time/ money in new systems and ways of working. Online access and consulting could reduce the need for attendance at GP practices and appointments in the long-term. How to apply the technology in ways which actually do this needs to be established by rigorous evaluation, rather just the belief that rolling out more online services will somehow inherently reduce workload.”

The Londonwide LMCs response to the digital-first consultation can be viewed here.

Babylon GP at Hand expansion

Babylon GP at Hand, the main digital-first NHS GP service, has recently expanded into Birmingham and is planning to launch in Manchester. At the end of September, it opened a new clinic in Raynes Park, Merton and has plans for further GP services in Upper Woburn Place, Camden and Bendall Mews, Westminster.

GP IT Futures suppliers

Separately to NHS England’s digital-first announcements, NHS Digital has named 70 approved suppliers for its GP IT Futures framework. The GP IT Futures framework is part of NHS Digital’s plan to allow more IT companies to produce applications and tools which will connect to the main clinical systems used by practices, such as EMIS and SystmOne.

The full list of suppliers can be found here.

Last updated : 31 Oct 2019