NHS: The Danger of Health Apps

Health leaders have warned that NHS health apps like the newly-launched “GP at Hand” offering free videolink appointments could split frontline services and leave at risk the older patients who need care the most.

Professor Helen Stokes-Lampard, chairman of the Royal College of General Practitioners, said older patients who need GP services would be left out by the digitisation of appointments.

“We are really worried that schemes like this are creating a twin-track approach to NHS general practice and that patients are being ‘cherry-picked’, which could actually increase the pressures on traditional GPs based in the community,” she said.

“There is an extensive list of patient conditions such as frailty, pregnancy and mental health conditions that are the essence of general practice and which GPs deal with every day, but which are not eligible for this service.

While this scheme is backed by the NHS and offers a free service to patients, it is undoubtedly luring GPs away from front-line general practice at a time when we are facing a severe workforce crisis and hardworking GPs are struggling to cope with immense workloads.”

Exclusions

Babylon Health, a firm that charges for app-based health services, explained to the GP’s magazine Pulse which patients may be excluded from its service.

The list included some of the most vulnerable in society such as adults who need safeguarding, people with complex mental health conditions, learning difficulties or dementia, frail older people, those needing end of life care, parents of children who are on the “Child at risk” protection register and drug addicts.

A representative of GP at Hand rejected the college’s criticism of such health apps. “The RCGP are completely incorrect to say certain groups of people are not eligible or excluded for this service,” he said.

“In line with NHS guidance for patients with certain conditions, as with any other care provider, our doctors will assess patients’ needs and in some circumstances may recommend other care is more appropriate and guide patients through getting that care, at all times putting the needs of the patient first.”

Balanced Funding

Stokes-Lampard also warned that GP budgets face a balancing act as funding is allocated to surgeries for each registered patient and the funds allocated for younger people subsidises the elderly who use the services more.

The frail elderly will not be accepted by the new health apps so the extra funds from healthier people will go to the app rather than the surgeries. That means private firms such as Babylon Health will take vital NHS funds as profit and leave traditional surgeries under even greater financial strain.

The result would not be more space in waiting rooms but surgeries potentially closing altogether if they cannot balance their books. The most ill in society could be forced to travel further to even more crammed surgeries.

Start Haggling

If apps like GP at Hand prove a success then more complex cases could be included in their remit in the future. But there will always come a point when detailed physical examination by an expert eye is necessary. The solution must lie with health leaders to use the weight of the NHS to hammer down the prices demanded by app-based private firms take over patients.

The same process already applies to drugs, as bulk NHS contracts worth millions are awarded to the pharmaceutical firms that are willing to undercut their competitors. Online healthcare is an amazing innovation that will be superbly convenient but it must not come at the expense of GP surgeries at the frontline of care.

The average payment to GPs for each registered patient is about £140 a year. A convenient app that slashes the time needed for appointments shouldn’t receive the same amount of money and the remainder could help to fund the patients the app cannot help.

by Stewart Vickers

 

 

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