GP at Hand is due to go live in Birmingham this morning after its expansion was approved by Hammersmith and Fulham Clinical Commissioning Group (CCG).

A number of restrictions were placed on the digital health provider’s operations in the West Midland’s city, which will be reviewed in eight weeks.

Hammersmith and Fulham CCG’s Primary Care Committee gave the go ahead at a meeting on 18 June with the service due to go live at 8am today.

The digital provider, powered by Babylon Health, will not be able to register patients outside the Birmingham and Solihull local governments for the first three months.

The app, which allows people to carry out video-consultations with their GP through their smartphones as well as triaging their symptoms, will also be limited to 2,600 registered patients until further reviews can take place.

It will be registered to Badger Medical at 121 Glover Street.

Dr Matthew Noble, UK Medical Director at Babylon Health, said: “Babylon GP at Hand is loved by patients as they can often see a GP within 30 minutes, it’s valued by GPs who can enjoy flexible working, it helps reduce visits to A&E and it doesn’t cost the NHS a penny more, in fact it can save the NHS money.

“The practice is open to everyone – for those with more complex conditions who really struggle with everyday living, we have a care coordination team that has frequent contact to help them manage.”

Currently GP at Hand has 54,700 registered patients, but only a small percentage live within the Hammersmith and Fulham catchment area.

The local CCG is footing the bill for the entire patient list, which has sparked heavy backlash from doctors and politicians.

As part of the expansion, Babylon will also be required to establish a “robust” screening solution within the next three months.

The primary care committee initially rejected Babylon’s move to expand to Birmingham, put forward in June 2018, with access to local and national screening programmes a point of concern.

The recently published independent Ipsos Mori review into GP at Hand also cited concerns with access to screening programmes, noting patients may be “less likely” to attend screening appointments.

The evaluation was “not able to fully address” whether the service is affordable or sustainable.

NHS England also objected to the application, but reneged in February 2019 after areas of concern were “resolved”.

Initial restrictions on geography and patient registration limits will be reviewed, and potentially lifted, after eight weeks of operating.

GP at Hand has been plagued by controversy since it was launched in 2017.

The service faced fierce criticism from Doctors in Unite, which called for the service to be scrapped amid fears it would “destabilise” other GP practices.

The MP for Hammersmith, Andy Slaughter, has called on the service and any potential expansion to be suspend until the NHS has a better understanding of how digital services will impact primary care.

He told Digital Health: “While the GP at Hand scheme is causing financial mayhem in Hammersmith and Fulham, and distorting the primary care market in London, it seems the greatest folly to allow it to launch a recruitment drive in England’s second city.

“Is it political influence or NHS inertia and bureaucracy that allows this cuckoo to demand to be fed from the health service budget? So many questions remain  to be answered about the way GP at Hand operates, but by the time they are answered it will be too late to stop patients, resources and technology being siphoned off.”

Mr Slaughter has previously written to Dr Sarah Wollaston, chair of the Health and Social Care Committee, calling for an inquiry into GP at Hand due to “serious concerns” about the app, including distorting GP funding as everyone who signs up for the service is automatically registered to the practice in west London and de-registered from their original GP.

In his letter to Wollaston, which he posted on Twitter, Slaughter also suggests that Hammmersmith and Fulham CCG was facing potential additional costs of more than £20million in order to continue funding Babylon’s GP at Hand practice, which is double figures reported in March 2018.

NHS England have agreed to help mitigate costs to the CCG in 2019/20 and the two parties are working through “technical issues” to see how this can be achieved.