A significant further roll-out of Babylon Healthcare’s GP at Hand service beyond London was reviewed after NHS England lodged a “formal objection”, it has been revealed.

The free NHS-commissioned and funded service promises to cut waiting times by allowing patients to book appointments and talk to their doctor through their smartphones.

However, the initial London launch was met with criticism from Local medical Committees. And a clinical review, published by Hammersmith and Fulham CCG, revealed Babylon’s desire to roll out the service across more GP practices in other English cities, prompting NHS England to issue a formal objection.

The review was commissioned by the CCG to “assess any impact on the quality or safety of care being offered to patients”, and suggests the service should be formally evaluated before being further rolled out.

Describing the service as “novel”, the review raises a number of potential risks of contributing to health inequalities and the impact the service will have on the “wider primary care provider landscape”.

It adds that the GP at Hand service has not been “formally evaluated”, which could result in “unintended consequences”.

However, the review did hail the service as an “innovative”, “exciting” and “potentially transformative” approach to general practice and healthcare.

In the recommendation section of the review, it states: “We would suggest that a rigorous evaluation framework be agreed with local commissioners and the NHSE Regional Directorate, to accompany a more gradual roll-out of the model that enables any concerns to be rapidly identified and learning applied to mitigate the risk of any detrimental impact.”

Proposals show Babylon responded by scaling back plans to expand the service from nine physical clinics, which included Birmingham and Manchester, to four.

The chosen practices will now all be in London and will be subject to a three-month evaluation period.

The proposal said: “We strongly agree with the need for a rigorous evaluation of the service.

“We will work with local commissioners and the NHSE Regional Directorate to make this happen.

“As the clinical review recommends, this evaluation would accompany the restricted roll-out of the service.”

A spokesman for Babylon told Digital Health News that since the review, commissioners accepted the company’s proposed changes to its expansion in November.

“Commissioners have comprehensively signed off our roll-out plan and we look forward to working with them to expand GP at Hand across the country,” the spokesman added.