The long-awaited and repeatedly postponed report on Babylon GP At Hand service has finally been published – but anyone hoping for clear answers to clear questions will be disappointed. The report does confirm suspicions that GP At Hand has predominantly recruited younger, fitter, more affluent patients.
It therefore implicitly concedes that by allocating enhanced resources to them the NHS has effectively drained resources from care of more vulnerable patients and older people with great and more complex health needs.
94% patients enrolled with BGPaH are aged 45 or under, and two thirds of them live in more affluent areas. Surprisingly this relatively youthful, wealthy and healthy patient cohort is actually also more likely than the average to make use of primary care, 111 and A&E services.
However (p80): “even if additional demand for primary or secondary care services had been observed in BGPaH patients, no conclusions could have been drawn on whether this demand was an appropriate use of healthcare resources.”
There are so many other conclusions that also cannot be drawn, according to the 93-page report. It repeatedly calls for further research and investigation. Among the key issues fudged is the key question of the cost effectiveness of the model (which cannot be assessed “due to the absence of data on patient outcomes” (effectiveness) – but also a lack of any information or transparency on the costs of the model. “For commercial sensitivity reasons, no data are available on the costs of maintaining the bank of GPs or the infrastructure development by Babylon.” The report does argue that it could still be cost-effective for the NHS to spend additional money on the BGPaH model … “if the outcomes for patients are sufficiently better than through traditional practice.” But are the outcomes better? “The evaluation team do not know if this is the case because data on patient presenting problems or outcomes was not available…”