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Harry Longman
Friday, 29 June 2018 / Published in Comment

Babylon/GP at Hand: GPs need to change their game

In this third instalment on Babylon/GP at Hand the cards are on the table, and you’ll see why.

I’ve looked at what they are getting right, patients’ desire for speed and convenience (don’t blame the patient, think of the last time you were one).  I’ve looked at their AI claims, partial, unproven but fundamentally a disease based rather than demand led model.

Now the nub of it:  GP at Hand is disrupting traditional practice with a city wide (London only for now) service attracting young, fit, male and mobile adult patients – your most profitable demographic.  The exclusions effectively mean

  • it’s not whole person
  • it’s not whole life
  • it’s not whole family
  • it’s not whole community

Even a normal healthy female would go through four changes of GP to use this service during her lifetime.

Infant – no.  Young adult – yes.  Mother – no.  Older adult – yes.  Elderly – no.  “All the world’s a stage…” but only bits of it are covered by NHS Babylon. (Kudos to them for getting Malcolm Grant onto their stage on Wednesday night btw.  What was he thinking?)

Let me be absolutely clear where we stand:  for high quality general practice covering the whole person, life, family and community. Sounds rather like the RCGP, indeed the NHS.  It has to be local to do that (and unit size is irrelevant, except to patient satisfaction which goes up as size goes down).

But to compete against the likes of GP at Hand, and to be profitable in ever more squeezed circumstances, you have to work much more efficiently.  Not lilttle 3% tweaks, but 30% leaps.  That is exactly what we do.

That kind of efficiency gain (Dr Sue Arnott, single hander, has 4,600 patients) is changing the economics.

The normal experience of askmyGP patients is to send a request online, get a response within minutes and for the 30% or so who need to be seen, it’s today.  The record posted last week was a feverish child seen within 12 minutes of sending.  GP at Hand can’t touch that.

Safety must be paramount, and two features of the system design are crucial.  Firstly it enables you to be responsive, easier to contact by phone as well as online, and we know the average practice should expect a couple of emergency presentations each week.  I would never have made this claim, but Dave Triska tweeted on Wednesday, “so far I can count 3 lives saved in 4 weeks by this method.”

Secondly, it enables and encourages continuity by allowing patient choice of GP, and giving GPs total flexibility within the day to provide.  Here is today’s BMJ paper, better continuity reduces mortality.

Increasing numbers of practices are asking us where to start, without leaping into the unknown (really not unknown, the once familiar delight of being a doctor) and that’s what we do wtih Pathfinder – Could you be ready to change?

It’s the kind of change which is necessary to stay the same.  Don’t give in.  Don’t see decline as inevitable.  Don’t expect bungs or contract changes to bail you out – not this five year plan.

Use the power you already have over your own destiny.

Harry Longman

PS  Please don’t believe me.  Believe the GPs doing it, and if you haven’t yet, hear the amazing interview with Dr Dave Triska.

PPS This tweet from Dr Lis Flett moved me:  “One of the two patients who wanted a face to face appointment this morning (that’s right, 2) sat with me for half an hour. Many problems solved, patient felt listened to: Medicine the way it should be.”

PPPS Just had an email from Babylon  “Babylon’s AI is on par with doctors”.  You. Could. Not. Make. This. Up.

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