GPs are in revolt over the serious financial threat from a new online service that is draining funding from surgeries for patients with the most complex needs and have called for the scheme to be axed. 

Unite, the country’s largest union, called on health and social care secretary Jeremy Hunt to scrap the model of care used by online NHS GP at Hand service which ‘threatens the very survival of NHS general practice as we know it’. 

The crux of the problem is that when patients register with GP at Hand, currently operating just in London, they are ‘de-registered’ from their own surgery with funding being removed from that practice. DiU is concerned that GP at Hand now wants to expand across England. 

In a letter to Jeremy Hunt MP signed by more than 130 health professionals, many of them currently working in general practice, Doctors in Unite (DiU) said that since the service launched in November 2017 ‘around 26,000 patients have registered with GP at Hand, most of these being between the ages of 20 and 39’. 

In the letter, DiU said: “Practices have seen their list sizes fall for the first time in years due to those patients registering with GP at Hand. 

“There is, no doubt, that GP at Hand will destabilise other practices, robbing them of the vital risk pooling and cross subsidy which enables them to provide good care to their more complex and unwell patients. 

“Losing registration fees for younger, fitter patients who join GP at Hand threatens the model of general practice relied on by so many patients. 

“The scheme is hoovering up the younger, healthier patient and restricts access to those who are pregnant, frail, terminally ill or suffering from multiple health problems. 

“Continuity of care is threatened because you may never see the same GP again when consulting GP at Hand. 

“In practice, 70 per cent of all patients are reasonably well. Their funding helps surgeries care for the 30 per cent who are sick. It’s a system that works, because it’s fair. We all eventually end up in the 30 per cent.”  

Commenting on the letter, DiU chair Dr David Wrigley said: “An increasing number of GPs are in open revolt at this online service that is seriously eroding the vital personal relationship between GP and patient, as envisaged when the NHS was set up in 1948. 

“The model of care used by GP at Hand should be scrapped immediately.” 


Notes to editors: 

For more information please contact Unite communications officer Barckley Sumner on 020 3371 2067 or 07802 329235. Email: 

  • Unite is Britain and Ireland’s largest trade union with over 1.4 million members working across all sectors of the economy. The general secretary is Len McCluskey.