GP at Hand: The latest must-have app or just a widening of the inequality gapp?

By Anne Fitzgibbon

Dating apps, take away delivery apps, photo editing apps and even the BNF prescribing apps have been phone essentials for a while now but recently joining the app world has been ‘GP at Hand’.

This NHS app boasts a 3 minute sign up and the opportunity to see a doctor in minutes with doctors in reach 24 hours a day and available to have a video consultation from your phone within 2 hours. The application is also free for all patients who leave their current NHS GP and register with this service. One is eligible if they live within 30 minutes of one of the five practises that the GPs work out of or work within zones 1–3.

There are some patients who may not be eligible to sign up:

• Women who are or may be pregnant.
• Adults with a safeguarding need.
• People living with complex mental health conditions.
• People with complex physical, psychological and social needs.
• People living with dementia.
• Older people with conditions related to frailty.
• People requiring end of life care.
• Parents of children who are on the ‘Child at risk’ protection register.
• People with learning difficulties.
• People with drug dependence.

The GPs providing consultations are all GMC registered doctors and have an average of 10 years experience. The app does not promise that you will get the same GP whenever you call up but it should be noted that all doctors talking to you would have access to previous health records.

Though the system seems more ‘handset’ than hands-on, the video consultation means skin rashes can be shown on screen and if you would like to review the consultation the recording is stored and your clinical records can be accessed on the handy ‘Me’ section of the app. The video calls are allocated a slot of 10 minutes, as is usual for general practise and the recommendation is that if the consultation is likely to take more than 10 minutes, that patients book a double video session.

For patients who are assessed via the video call and deemed to need a face to face appointment these are also possible to arrange between certain hours Monday- Saturday at selected sites. There are currently five practises offering their services in London, the nearest to UCL being in Drummond St, Kings Cross.

There has been a mixed response from the medical community. Prof. Helen Stokes-Lampard, Chair of the Royal College of GPs commented in November that whilst the app does offer the opportunity for young patients who fit the criteria to get medical help more quickly there was a risk that GPs would be ‘lur[ed] away from frontline general practise at a time when we are facing a severe workforce crisis’. In her statement she made it clear that the ‘real and long-term solution lies in greater investment in general practise In England… this would mean £2.4 billion extra a year for general practise, 5,000 more GPs, and 5,000 more members of the practise team.’

She is certainly not alone in being hesitant to offer support. At a BMA conference in November of last year, there was criticism of public money being used ‘to promote inequitable access to NHS branded services.’ There was widely expressed concern that the scheme would be excluding the elderly, and Dr Susie Bayley said she opposed the app, bringing into question the moral standing of an app that favours the well over the ill.

In any case, the app is still up and running, the website highlights their 4.8 stars review and offers links to twitter accounts and reviews. Other than two patients who were unhappy that they had not been given antibiotics the reviews of patients are pretty good, with many 5* reviews and ‘excellent, quick and easy’ being the general consensus. The fear of disjointed appointments given different doctors consulting each time seemed to be allayed with many commenting that it was clear the doctor had read the previous consultation notes and that the appointment was a success.

For now it seems the jury is out, I won’t be leaving my practise any time soon but will be on the lookout when the results of the three month evaluation is published!

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Bodkin, H., 2017. Doctors threaten court action in bid to prevent smartphone consultation service from going ahead. The Telegraph.

Hand, G. at, 2018. NHS Doctor Appointments Online [WWW Document]. GP at Hand. URL https://www.gpathand.nhs.uk(accessed 2.8.18).

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New GP app could lead to patients being “cherry picked” and create “twin track” general practice, warns RCGP [WWW Document], n.d. URL http://www.rcgp.org.uk/news/2017/november/new-gp-app-could-lead-to-patients-being-cherry-picked-and-create-twin-track-general-practice.aspx (accessed 2.13.18).

NHS England London » GP at Hand — Fact Sheet [WWW Document], n.d. URL https://www.england.nhs.uk/london/our-work/gp-at-hand-fact-sheet/ (accessed 2.8.18).

NHS offers smartphone GP appointments, 2017. . BBC News.

November 2017, 8, n.d. “We have a number of serious concerns about the GP at Hand service” [WWW Document]. Pulse Today. URL http://www.pulsetoday.co.uk/your-practice/practice-topics/it/we-have-a-number-of-serious-concerns-about-the-gp-at-hand-service/20035632.article (accessed 2.8.18).