Expansion of & # 039; GP by Skype & # 039; service risks worsening GP crisis

Expansion of controversial & # 39; GP by Skype & # 39; service to be offered to every patient by 2021 risks risk exacerbation of UK general practitioner crisis, Cambridge professor warns

  • The app for general practitioners is already well established in London and is being rolled out
  • But there are concerns that it takes money away from traditional practices
  • Healthier patients leave GPs with sicker patients with less NHS funding

Babylon & # 39; s door-to-door app (photo) is already being used by tens of thousands of patients in London and will be rolled out across the country

Babylon & # 39; s door-to-door app (photo) is already being used by tens of thousands of patients in London and will be rolled out across the country

Plans to replace traditional general practitioner appointments with virtual online doctors can undermine the care of older patients & # 39 ;, experts have warned.

Health Secretary Matt Hancock has promised to roll out a controversial plan in the NHS – but there are fears that it can skim off young patients & # 39; and the & # 39; digital divide & # 39; in healthcare.


The smartphone app GP at Hand uses an algorithm to assess the symptoms via a & # 39; chatbot & # 39; and offers ten-minute video appointments with a doctor.

It is already available to millions of patients in London and Birmingham, and Mr. Hancock is one of the 55,000 people who have signed up with their doctor to use the service.

But most people who have registered are young and rich and only 0.1 percent suffer from chronic conditions.

This can affect traditional GP practices because they receive a fixed amount of £ 150 for each patient in their books, meaning they lose money when patients leave to participate in the online schedule.

And because it is mainly the young and fit who register, operations are left with a higher percentage of precious patients – such as the elderly, vulnerable and chronically ill.

Professor Martin Rowland of the University of Cambridge warned yesterday that virtual GP apps threaten to skim off young patients and not respond to the wider needs of the population.

The former doctor wrote in the British Medical Journal: & For most patients, Hand doctors are unable to visit at home or in nursing homes.



The UK GP crisis is an ongoing issue where GPs are struggling with increasing work pressure while staff numbers are shrinking.

A record of 138 operations was closed in England last year, at a rate of two per week, affecting more than 500,000 patients.

The population of the UK is gradually getting older as people live longer, and there are more and more people living long with complex health problems.

These are the ones who need ongoing medical care such as diabetes, heart disease or dementia – and many people have more than one.

GPs also leave the profession faster than they join, which means that the growing workload does not have a growing workforce to pick them up.


Figures in May showed that there are 28,697 fully qualified general practitioners working in England, compared to 29,379 in 2016.

Since March 2016 – the first year after the government had promised to hire 5,000 extra GPs by 2020 – the total number has fallen by 682.

Data for the first three months of this year also showed that waiting times are becoming longer.

The number of people waiting more than two weeks to see their GP in England rises to 12.3 million this year, an increase of 14 percent compared to 10.8 million in the same period last year and represents a total of one out of six patients.

& # 39; Some fear that the new service will fatally undermine traditional family practice, allowing GPs with sick and complex patients to ensure fit young patients.


& # 39; It essentially takes money away from practices. & # 39;

It comes when Great Britain is confronted with a spiral of general practice. Last year, a record 138 operations were closed and millions were struggling to make appointments with a doctor.

Mr. Hancock believes that technology can offer a solution.

He said last year: & # 39; GP at Hand works brilliantly for so many patients and fits the way people access modern services. & # 39;

But GPs are concerned that virtual consultations lack fewer obvious symptoms that doctors pick up through their instincts.


They are also afraid that the app will undermine the doctor-patient relationship and alienate people without smartphones.

Professor Helen Stokes-Lampard, of the Royal College of GPs, said the GP at Hand app is & # 39; risk & # 39; s for destabilizing traditional NHS GP practices & # 39; and said it was not suitable for people with complex health needs and patients who appreciated the continuity of care.

And she warned: & # 39; We have not yet had a comprehensive independent evaluation of how safe the service is for patients.

& # 39; Those who do not have access to suitable smartphones cannot use the new models offered, widening the digital divide in healthcare. & # 39;

A NHS spokesperson said that GPs' financing arrangements had been changed to take into account new digital services, and added: & # 39; The NHS is committed to supporting GPs to increase the use of digital technology, with every patient in England having access to online and video consultations by 2021. & # 39;

Babylon, the company behind the app, said the NHS had to decide whether to protect & # 39; old-fashioned GP practices, or do the right thing for patients and taxpayers & # 39 ;.

  • One in three general practitioners did not properly diagnose a patient because they missed symptoms during a ten-minute consultation. The Royal College of GPs wants longer appointments of 15 minutes.
Health Secretary Matt Hancock has made it one of his top priorities to promote the use of technology in healthcare and is an open advocate of GP care

Health Secretary Matt Hancock has made it one of his top priorities to promote the use of technology in healthcare and is an open advocate of GP care

Health Secretary Matt Hancock has made it one of his top priorities to promote the use of technology in healthcare and is an open advocate of GP care


One in three NHS GPs admits that the appointment duration is limited to 10 minutes, which means they have missed symptoms, a study found.

Wrong diagnoses mean that patients have to return for extra appointments and can become seriously ill, which means a greater use of NHS time than a longer consultation in the first place.


Slater and Gordon law firm interviewed 200 doctors about their workload and 94 percent said that appointments should last at least between 16 and 20 minutes.

Four in five said they did not always have time to properly diagnose patients, with 55 percent fearing they had missed serious health problems.

A doctor said: & # 39; I often do not have enough time to spend with one patient to make a correct diagnosis.

& # 39; Recently it took three weeks and repeated appointments to understand the medical condition of a patient and offer the right solution.

& # 39; If we had had more time at the first appointment, I could have proceeded immediately with her complaint. & # 39;


Dr. Eleanor Holmes, a 39-year-old GP in Newcastle, is on sabbatical due to stress after 10 years of working in the field.

She said she often saw about 30 patients a day during a 10 to 12 hour shift.

& # 39; For most GPs, it is like sitting on a treadmill, & # 39; said Dr. Holmes.


& # 39; You are treated as replaceable machines under constant pressure. Most GPs want to do their utmost for their patients, but the system does not allow this.

Doctors often run out, suffer from serious psychological problems or leave the profession. & # 39;


Parm Sahota of Slater and Gordon added: & We trust our GPs to listen to our concerns and identify any issues without worrying about rushing to unsafe deadlines that are not good practice.

& # 39; They must have sufficient time to do their job properly and robustly for the health of the UK. & # 39;

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