The Royal Berkshire Foundation has paid private healthcare company Babylon Health for access to an A&E triage tool that is almost identical to many of the services NHS 111 provides. The contract, awarded in mid-May, is the company’s third with a hospital trust and will give the trust 12 months access to Babylon’s Ask A&E triage tool. The amount paid for the contract has not been disclosed.

An article in the HSJ, notes that this could be the beginning of a longer term partnership similar to the previous two agreements with the Royal Wolverhampton FT and University Hospitals Birmingham FT.

Patients can input their symptoms into the Ask A&E tool now available online via the trust’s website. It will provide advice to the patient based on symptoms, which could be visiting A&E, calling an ambulance, seeing a GP, or staying at home and monitoring symptoms.

The system does not differ much, if at all, from the current NHS 111 service, which in the trust’s area is provided as part of an integrated urgent care service by South Central Ambulance Service NHS Foundation Trust (SCAS) in collaboration with Berkshire Healthcare NHS Foundation Trust, Oxford Health NHS Foundation Trust and Buckinghamshire Healthcare.

Umang Patel, Babylon’s director of NHS services, told HSJ that the system “doesn’t differ massively but it’s more the process of getting to that information.” He added that “111 is more orientated to phoning up a number and looking for an immediate solution, and that’s designed to take pressure off the 999 service…..We’re trying to help people use a more sustainable resource for self-help, which they can use at their own pace.”

Trust chief executive Steve McManus said in Babylon Health’s press release: “With 111 being extremely busy at the moment, the Ask A&E service offers a trusted way to get information from the NHS.”

However, it’s clear that the integrated urgent care service in the trust’s area is much more than just taking the pressure off the 999 service, it can signpost patients to all manner of help, such as pharmacies, GPs and mental health workers, as well as transfer a patient to be assessed by nurses. It can also send an ambulance should that be necessary.

Add to this, the fact that the NHS 111 service can also be accessed online and from the NHS app, where in many cases on the NHS app it’s possible to message your own GP, it would appear that the Ask A&E tool actually provides a lesser service than NHS 111. 

Comments under an article on the contract on HSJ highlight the duplication of service, including noting that if a CCG commissioned this service, it would then have to decommission the NHS 111 service currently running as it would be a duplication.

The cost of the contract has not been published, but a freedom of information request has been sent asking for disclosure of the cost of this contract. 

However, whatever the cost, it’s puzzling why, with all the NHS 111 expertise available either at the end of a phone line, online or via an app, the Royal Berkshire Trust has done this deal to duplicate these services. If the NHS 111 service is overwhelmed, then the money might be better spent on bolstering the service or on better signposting the online NHS 111 or the use of the NHS app to take the pressure off the phone service. 

As well as the cost of the Babylon services, safety and security is also be a factor. Digital health services have become a major part of the way NHS organisations have responded to the pandemic, however these services are new and untested on such a large scale. Babylon Health’s GP at Hand app has been repeatedly criticised for responding incorrectly to symptoms in a way that could lead to very serious consequences. And Babylon Health suffered a security breach recently whereby a subscriber could see other people’s video consultations. NHS 111, on the other hand, is a tried and tested system without these concerns.


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