Friday, 12 January 2018

Babylon on-line triaging not coming to Brent

From the Health Service Journal LINK
 
Commissioners in London have ditched a planned pilot of Babylon Health’s primary care app after patients in a test “were typically most interested in using the app to speed up GP access, rather than [using] the symptom checker”.

Clinical commissioning groups in north west London were testing Babylon’s app as a tool for reducing GP attendance, by triaging patients online.

North West London Collaboration of CCGs confirmed it had “considered” piloting the Babylon app but it was dropped after tests with patients.

A spokeswoman told HSJ:
“The CCGs considered the merits of this app as a tool to help manage demand on GPs – particularly through the symptom-checker feature.

“We worked closely with patients to find out what demand there was for the app. We found that patients were typically most interested in using the app to speed up GP access, rather than the symptom checker.”
A Babylon spokesman said:
 “Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently a decision was taken not to fund the pilot.”
The CCG collaboration comprises Brent, Central London, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow and West London.
 
A CCG collaboration spokeswoman also said:
 “The information gathered from talking to patients was successful in informing the ongoing work of the sector as we explore this area further.”
It comes after a board paper for the CCG collaboration, dated 25 October, said that in the test of the app patients “effectively manipulated the system in order to secure GP appointments”.

The collaboration has, since this piece was first published, stated that this board paper was incorrect, and amended it.

The new paper says:
 “The board was updated on the evaluation work undertaken to inform a decision of whether to initiate a pilot with Babylon to see if the technology could drive reductions in demand for GP appointments.

“Work over the summer with focus groups to gather insights around perceptions had raised a concern that patients who might use the app could mainly do so because they believed it would get them faster access to GP appointments.

“The focus groups had also commented that there is a risk of some people gaming the symptom checker to achieve a GP appointment.

“The insights gathered therefore revealed that the symptom checker in particular was unlikely to reduce demand on GP services. This reduced the intended benefit of the system significantly. Following questions and further discussion, the board agreed not to proceed to the pilot stage.”

Another board paper from the chief executive of the CWHHE CCG group, in North West London, also dated October, said the app was tested with a “small group of patients” – the test “spanning six patient focus groups and a wide demographic area” in September. The plan had been to move later to a wider pilot involving about 16 GP practices.

Babylon, along with several emerging competitors, is a private company that provides on demand video GP consultation and a chatbot style symptom checker from a smart phone app.

The Babylon app is available privately for a monthly fee but is increasingly also being offered free to NHS patients through their GPs.

Babylon, headed by Circle founder Ali Parsa, is also heavily involved in several national projects with NHS England that, if successful, could lead the company to playing a major role in delivering online NHS services.

Concerns about Babylon’s role in the NHS increased this month after the company launched GP at Hand, a collaboration with London GP practices that will make its video consultation freely available to any NHS patient that switches to participating practices.

GP at Hand has been accused, mostly by GPs, of “cherry picking” relatively healthy patients and excluding those with more complex health needs.

A week after the service was announced, the London local medical committees passed a motion calling for a halt to the deployment of online GP services in the NHS until there was more robust evidence they benefited patients.

The north west London testing was part of the CCGs’ aim to use online consultations to reduce GP demand, as outlined in the area’s sustainability and transformation plan.

The Babylon project was funded by Health Education England with much of the assessment work carried out by Imperial College Health Partners. These organisations will continue to research alternative digital tools for accessing GPs in north west London.

A collaboration spokeswoman said: “The information gathered from talking to patients was successful in informing the ongoing work of the sector as we explore this area further.”

An HEE spokeswoman said the organisation had worked on a pilot with the CCGs and ICHP looking at digital solutions to free up time for busy practices, as well as how staff could be trained to use new technology. She added: “There is ongoing evaluation of this work and HEE continues to work with the STP and the CCG in looking at transformation of the workforce.”

Babylon’s full statement to HSJ said:
 “The NW London CCGs’ collaboration board paper item ‘NW London Babylon Pilot: Emerging findings’ is factually incorrect and deeply misleading.

“No pilot was ever carried out, nor any agreement signed with Babylon for such a pilot. Discussions were held after Babylon was selected in a competitive procurement exercise as the best technology to trial in GP practices across North West London. Subsequently a decision was taken not to fund the pilot.”
Babylon said in a further statement to HSJ this week:
“We have no assurances that any meaningful and robust user tests were ever carried out, and Imperial College Health Partners were not involved in any such testing.”


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