Londoners: Ready to swap your GP for an NHS vid doc app?

Londoners are being given the choice of putting their health in the hands of their internet connection, via a 24/7 app-based NHS service which will allow them to have consultations with doctors over video call. The GP at Hand service has been rolled out for 3.5 million eligible in the UK capital. It uses a platform operated …

[0laf]

Choice

I think with choice being available this sort of thing could be useful in some circumstances to some people.

But many problems need a hands on approach by a doc to get to the bottom of the problem. And also some people will be unable to get to grips with an app based solution or might not have a capable phone. Many of those patient will be the docs most regular visitors, i.e. the elderly.

The cynic in me thinks choice won't be there and we'll all have to be screened by the robo doc before we're worthy of making an appointment. Also it'd make charging for missed appointments nice and easy wouldn't it?

[John Brown (no body)]

Re: Choice

"we'll all have to be screened by the robo doc before we're worthy of making an appointment."

You mean the receptionist?

[Anonymous Coward]

Re: Choice?

Like the choices I am given by the GP when I visit?

"What would you like me to do?"

Um, be a GP, help me get well? I feel unwell!

"Well what is wrong with you?"

Um, I guess that's why I'm here... to ask you. If I knew, I'd be at the pharmacy!

[werdsmith]

Re: Choice

But many problems need a hands on approach by a doc to get to the bottom of the problem.

Or there could be a special rubber glove attachment for phones?

[Peter2]

Re: Choice

To be frank, a great deal of time and money could be saved by asking "is this an infections disease eg cold, flu, other" remotely.

From there, ask if they are demanding antibiotics (and do they realise that these are pointless as can't cure either colds of flu and only increase antibiotic resistance) and if they are still demanding antibiotics then post placebo-icillin to them.

That way the people with colds and flu wouldn't end up infecting everybody at the GP's surgery and the doctors there could get on treating people who actually need their attention.

[GP at hand]

Re: Choice

Thanks for your comment, Olaf.

Our experience has shown that the majority of GP appointments can be carried out on the patient's phone, either by a video or a voice call. However, there are always some medical issues that require a face-to-face appointment which we can organise at the patients choice of our clinics.

GP at hand is a service that gives patients a choice about the way they can access a GP around their busy lives.

We will always give people clear info about the service and help them to make the right decision for themselves to register.

GP at hand is an NHS service, free at the point of use with absolutely no hidden charges.

Matt

[zeptepi]

Re: Choice

"Our experience has shown that the majority of GP appointments can be carried out on the patient's phone"

Don't believe this: it has not been published in a peer-reviewed journal.

And don't kid us that you're an NHS service: being free at the point of use is only part of being real NHS, the part any spiv can price into their business model. The other part is Universal Coverage, and you are flagrantly breaching that by cherry-picking the fit and easy cases.

You are also "passing off" this service as if a GP service. It may be staffed by GP-trained cyber-docs, but where is the service to the local community co-ordinating all local health and care resources? And I know of no real NHS GPs who don't protect the privacy of medical data, and are proud of that condition of their licence.

[Aladdin Sane]

"your electronic record continues to be safely held in the NHS IT system"

My sides! They are splitting!

Maybe the app could teach me how to do my own sutures?

[Anonymous Coward]

"If Babylon Healthcare Services Limited or substantially all of its assets are acquired by a third party, personal data held by Babylon about its customers will be one of the transferred assets."

I see absolutely nothing wrong with this statement if I was the sort of person who didn't care where my medical records ended up. Interestingly could this be so Google can buy them out at some point in the future?

[Adam 52]

According to their privacy policy they can already share your data with Google:

"(b) provide such information to any member of our group, or Affiliates, business partners, suppliers and sub-contractors of the Company where reasonable or necessary in relation to the provision of the products and services"

[Adam 52]

...and Equifax

"(h) assist in the detection of fraud."

[Anonymous Coward]

Mother in Law

Excellent! I've signed up the mother-in-law. What could possibly go wrong?

[Rich 11]

Re: Mother in Law

She gets better?

[Anonymous Coward]

Can't come soon enough

I can't be the only one who doesn't have time for going to see a GP. This looks like a massive productivity gain for people who're actually working during the day... Surprised at the number of ludites on this site...

[Anonymous Coward]

Re: Can't come soon enough

What if you really need to go in and see the doctor? Are you going to listen to your own chest and heart?

What if you are disabled with limited mobility?

What happens when this is the only option and they have outsource it to an overseas doctor call centre?

It's not that people are ludites it's just that when some trial like this happens it usually doesn't end well for the user and what may work well for 80% harms the other 20%.

[JEDIDIAH]

Re: Can't come soon enough

This seems like something that might work for dermatology but not much else.

[Prst. V.Jeltz]

Re: Can't come soon enough

What if you really need to go in and see the doctor? Are you going to listen to your own chest and heart?

I think this system may have many benefits, when used alongside actual visits to the GP.

[John Brown (no body)]

Re: Can't come soon enough

"I think this system may have many benefits, when used alongside actual visits to the GP."

Yes, it would make sense for this or similar to be part of NHS Direct, but it seems the operators of the system are planning on getting rich from it and being nation/world-wide GP service and to be part of it you have to transfer from your current GP to the new virtual GP service.

[BrianT]

Re: Can't come soon enough

"What if you really need to go in and see the doctor? Are you going to listen to your own chest and heart?"

No, if you actually knew what the service included you wouldn't need to ask such a question.

The service includes a guaranteed face-to-face consultation within 48 hours when needed. That's about 12 days quicker than a lot of us have to put up with. If you need to go in and see the doctor then that is what you do and within 48 hours.

[Anonymous Coward]

Re: Can't come soon enough

Look, if I thought just chatting to a doctor would solve what was wrong with me, without him actually examining me, then I suspect I wouldn't bother to go and see him.

I actually have an appointment to see my GP soon. He's almost certainly going to need to do a rectal examination. How, exactly, is that going to work over a video link?

[Kernel]

Re: Can't come soon enough

"I actually have an appointment to see my GP soon. He's almost certainly going to need to do a rectal examination. How, exactly, is that going to work over a video link?"

Please don't tempt me with statements like this first thing in the morning while the mind is still firing on all cylinders - you may, however, wish to consider the purchase of one of the smaller smart phones as opposed to one with a "phablet" form factor.

[Korev]

Re: Can't come soon enough

I actually have an appointment to see my GP soon. He's almost certainly going to need to do a rectal examination. How, exactly, is that going to work over a video link?

Maybe they could use some kind of Android to do the procedure

[Anonymous Coward]

Re: Can't come soon enough

I did see an attachment for sale at the local car boot that does plug into a phone... oh and plugs into something else too...

[Anonymous Coward]

"rectal examination"

I don't know and I'm not going to search on google to find out if it's possible on video.

['s water music]

Re: Can't come soon enough

I actually have an appointment to see my GP soon. He's almost certainly going to need to do a rectal examination. How, exactly, is that going to work over a video link?

Duh, WeVibe of course.

But srsly, good luck with the visit

[Anonymous Coward]

Re: Can't come soon enough

"You want me to stick the phone WHERE? With the torch on?" 'nuff said.

[NonSSL-Login]

Re: Can't come soon enough

Incidentally, a triage nurse at A&E in the early hours used her mobile phone camera LED as a torch to look for whatever was stuck behind my eye irritating it.

All I could think of was how battered and dirty the leather folding case on her phone looked as it swayed about while she blinded me with the LED.

Based on that clearly anecdotal argument, im against phones in the medical profession unless there is a clear benefit.

But sod giving all my personal medical data over to any company, let alone one with the slightest of connections to Google.

[John Brown (no body)]

Re: Can't come soon enough

"I can't be the only one who doesn't have time for going to see a GP."

If your time is more important than your health, then maybe you aren't so ill as to need an appointment in the first place.

[jlavery]

Re: Can't come soon enough

So you're not ill enough to bother then.

So it's all right to expect the GP to work late and staff a reception desk so you don't have to put yourself to any inconvenience and pop along after work?

Smacks of 'my time is more important than yours'.

[veti]

Re: Can't come soon enough

So you're not ill enough to bother then.

Fallacy of the excluded middle. "Being ill" isn't a binary thing.

Obviously there are people who are perfectly well, and don't need to see a doctor. And there are people who are really ill, and do.

But there's a huge swathe of people who are pretty much OK, but they have a persistent headache, or a cough that just won't go away even after three weeks, or a pain in the back that they can work through but it doesn't seem to be getting better, or... whatever. And they could take it to a doctor, but it doesn't quite seem worth it, not yet anyway.

[Anonymous Coward]

Re: Can't come soon enough

> a persistent headache, or a cough that just won't go away even after three week ... And they could take it to a doctor, but it doesn't quite seem worth it, not yet anyway.

All possible symptoms of cancer ... nicely chosen examples of something that seems minor, but may very well not be.

[Prst. V.Jeltz]

Re: Can't come soon enough

And they could take it to a doctor, but it doesn't quite seem worth it, not yet anyway.

You know whats missing from this equation? non-instant , non volatile communication.

We spend weeks or months arranging for a single conversation , which in 5 seconds might produce a question or course of action that ends the conversation because more time is needed to get an answer , eg:

"hi doc, glad to see you at last , i keep getting a stabbing pain in the eye when drinking tea"

"does it go away if you take the spoon out?"

"i dont know , ill go away and try that , then book another face to face appointment in 8 weeks to verbally tell you the answer..."

WHATS WRONG WITH EMAIL? The gift of writing? the cornerstone of any civilized society?

this is why people turn to amateur idiots on the internet for health advice - at least they've got the communication part sorted out.

[Alex Read]

Re: Can't come soon enough

I’m all for progressive change. If this was solely in-house I’d think it’s an interrsting additional offering for the 21st century.... but by any company affiliated in the slightest way with google & they can fuck.right.off!!!!

[Blotto]

Re: Can't come soon enough

@AC

I've used Babylon successfully a couple of times.

i had a succession of ear infections, saw a real doctor who's advice made it worse, saw a Babylon doctor at home on a Saturday afternoon at a time of my choosing, got a prescription of antibiotics sent to the local pharmacy and collected later. I only get 7 days worth & the infection came back, saw a different real doctor, again no help and made it worse still, got home, contacted Babylon, got another course, which i stretched out whilst I resolved the reason why I was getting infections.

SWAMBO has a different Dr's surgery, she goes in complaining of something or other & doesn't tolerate anti biotics well, gets 2 weeks of double strength 3 times a day of the antibiotics i got which did nothing for her.

i mention this to highlight the inconsistency of different doctors practices. & yes i should probably change my Dr's to hers.

My doctors a 10 min drive from my home, takes ~ 15 mins to park if there is a spot in the multi story car park that they have divided and closed of half for no good reason plus 5 mins getting a ticket then always ~ 1 hour waiting in reception, so round trip to see the Dr's is about 2 hours. Online video appointment is much quicker as i get to wait at home or the privacy of my car if at work and i've been getting much better treatment.

[strum]

Re: Can't come soon enough

>I can't be the only one who doesn't have time for going to see a GP.

If you don't have time to visit a GP, there's a fair chance you don't need to. But if you really need medical treatment, you'll make time.

[Robert D Bank]

One great stride to privatisation of the NHS

I wonder if that Mr 'unt has invested in this firm?

[Anonymous Coward]

How does this differ from push doctor?

[Anonymous Coward]

Push Doctor is a private service that you use on an ad-hoc basis if your GP is a bit too busy, while GP At Hand is a NHS service that completely replaces your existing GP registration.

[BongoJoe]

So, they are able to prescribe medication and to write referral letters to consultants?

[Queeg]

"I swore I'd never use one of these"

"Computer activate the Emergency Medical Holographic program"

.

.

"Please state the nature of the medical emergency."

.

.

"There are 15 angry Octogenarians about to come through that door"

.

.

* I wouldn't laugh to soon if I were you.

[JEDIDIAH]

Re: "I swore I'd never use one of these"

I would be surprised if octogenarians had the strength for that kind of shenanigan. They're more likely to be drooling, deranged, and restricted to wheelchairs.

[Martin]

Re: "I swore I'd never use one of these"

I would be surprised if octogenarians had the strength for that kind of shenanigan. They're more likely to be drooling, deranged, and restricted to wheelchairs.

The average octagenarian is likely to be perfectly intelligent, and probably walking a bit slowly, perhaps with a stick. And if you made that sort of ridiculous comment to my octogenarian mother, she would, quite reasonably, hit you with it.

[Anonymous Coward]

Re: "I swore I'd never use one of these"

If you made it to your 80's then you are probably in good health.

Have you not wondered why over 50's life plans are so cheap?

[Pen-y-gors]

Pharmacist

By the looks of it, most of what they offer to deal with (i.e. nothing actually serious) can equally well (and more safely) be dealt with by having a word with a convenient pharmacist (just walk in off the street at a time convenient to you, no need for appointments). They will either be able to deal with your little problem (rub this cream on the affected area 3 times a day) or say that you really, really need to see a GP NOW.

Really handy and helpful

And of course some GPs are easing pressure on appointments by having more Nurse Practitioners, who can prescribe, thus leaving GP to more complex things and form filling.

This one really should sink with all hands.

[Anonymous Coward]

Re: Pharmacist

Indeed. They can replace Dr Patel (Sr) with an Android app, and I won't care, but if they replace the nice Nursey, I, for one, will be going elsewhere.

[Blotto]

Re: Pharmacist

@Pen-y-gors

I really don't understand the opposition some people have to progress.

How do you feel about people using technology like the phone to make an appointment as opposed to turning up and waiting in line?

Some people will need to be in the same room as the Dr, for others a chat over the phone or video appointment is sufficient.

[Alan Edwards]

Re: Pharmacist

> I really don't understand the opposition some people have to progress.

I'm not sure it's opposition to progress, it's opposition to handing it all over to an external 3rd party company.

My opinion? It should be an extension of the existing NHS-run non-emergency phone service, not an all-or-nothing that makes you switch GPs.

For all it's failings, at least you know the NHS is not going to sell your medical history to advertisers. Or insurance companies.

Ob. Douglas Adams reference: "I've gone off the idea of progress, it's over-rated"

[TheSingingProfessor]

I recall there was a sketch on the Two Ronnies about something like this. Ronnie C played his 'Raincoat' character, while Ronnie B was the TV-based doctor.

I'd pay good money to go to any surgery where the VR doctor was played by Mr R Barker...

[Anonymous Coward]

Quotas

Will the app nag me to take Statins based on the pretext that "all men over 60 should be taking Statins" as my GP practice does.? Not sure why they do it, maybe they have a quota to meet or a financial incentive.

(I'm going AC on this one in case they read El Reg in the practice and can put 2 and 2 together.)

[Anonymous Coward]

The Doctors are complaining....

....but maybe they are part of the issue?

They moan about patients missing appointments, so how come if myself, or the kids have the first appointment, we STILL have to wait 30 bloody minutes after it is set for?

Add to the fact you have to be sick on a Tuesday in four weeks time, between 11:00 and 11:15 or if you need, we can make it a Thursday in 14 weeks time between 15:00 and 15:15.

If you are really ill, they you could try calling in between 8:00.00 and 8:00.01 and you may get an appointment that day, if we decide to answer the phone.

[David Roberts]

What exactly is this supposed to save?

A video consultation with a GP is unlikely to be faster than a face to face consultation.

So you don't "see" more patients.

Also, there are many things (the word palpate comes to mind) which as far as I know you can't easily do via a phone.

As others have noted there are a number of things your GP can do face to face (or whatever) as a diagnostician which can't be done over a phone. There are a raft of other services including minor surger offered by many GP practices. How does this online practice expect to provide such things?

Looks very much like an attempt to avoid all the infrastructure costs and get a book of generally fit patients who rarely if ever need a consultation. Plus hypochondriacs.

[Adam 52]

Re: What exactly is this supposed to save?

By way of example, I broke my arm whilst on holiday. It was fairly obvious that it needed surgery but the hospital wouldn't take me without a referral and my GP couldn't see me because I was 1,000 miles away (and there were no appointment slots for a fortnight).

A phone call would have allowed my GP to refer me to the hospital.

Similarly I have a genetic condition that needs hospital treatment. There's nothing useful a GP can do about that, it's an inevitable consequence of my parentage, so an automated remote referral to the hospital would save all concerned much time and effort.

But GPs insist on a pointless 10 minutes face-to-face in person in an inconvenient location.

Nothing in my examples needs a video call, email or phone would be fine. I'm a strong believer in abolishing GPs entirely for situations where you need a specialist or where the diagnosis is so trivial that the little old lady from St John's Ambulance could do it.

[James 51]

Re: What exactly is this supposed to save?

@Adam 52, you have to see the GP now because of paitent lead care, they are the ones that control the money. The hospital won't be paid for treating you if the GP doesn't sign off on it first. There are certainly situations like yours where this is a wasteful system but that's what they Tories have lumped us with.

[Adam 52]

Re: What exactly is this supposed to save?

Signing off budget doesn't need 10 years of medical experience. Can (and was when I worked in general practice) be done by a admin person on minimum wage.

But yes, this is a consequence of Margaret Thatcher's GP fundholding reforms.

[Alex Read]

Re: What exactly is this supposed to save?

building assets. Then later via offshoring, labour costs too?

[Anonymous Coward]

Rectal Exam

Sorry, but I can't leave this alone, if you know what I mean.

I am in the know and I can tell you that each patient will be issued a mobile phone device for this very purpose - the Hemorr-Dhroid, with the Malteser OS installed

Boom boom - tish

[Haddion]

Aren't NHS GPs paid per registered patient...

...whether they come in or not?

>>Dr Neil Bhatia claimed that GP at Hand's potential patients are those "least likely to need to make contact with GP services in the first place", referring to the many conditions excluded from registering, such as pregnancy, mental illness and "complex physical, psychological and social needs"<<

If so, this sounds like cherry-picking to me. GPatHand gets a bunch of 'easy' patients to deal with for the same money as an 'area' GP has to deal with whatever comes in the door and registers. Are other GP surgeries allowed to disallow various pre-existing conditions when registering patients?

[zeptepi]

Re: Aren't NHS GPs paid per registered patient...

Indeed, real NHS GP practices are not allowed to cherry-pick the fit and easy patients, and it is not OK for a service that benefits from NHS branding and publicly-paid infrastructure such as their IT incl. Electronic Prescription Serrvice, and funding from the same pot so defunds the remaining services provided by real GPs.

Yes real GPs – because this also “passes off” these GP-trained cyber-docs as if they are real GPs serving a real community by hands-on care, and by co-ordinating local resources, and all with preserving privacy cos their licence depends on it.

This service should be explicitly private, to introduce funding from the user for their own convenience, as a top-up model to the real NHS.

[Anonymous Coward]

Smoke and mirrors

This is the same company that splurged loads of VC cash on an "AI" chatbot in their NHS-partnered 111 app. That was meant to be a 6-month trial starting in January. If I look, I see all of 10 people who've commented (mostly negatively) on the app in the Android store. Where are the findings? What sort of a nonsense AI division (or smart AI researchers fronted by nonsense AI division leadership) must they have going on there?

Be good to have you guys take a look into that one, El Reg :-)