GP at Hand is in discussions to expand to Manchester early next year.

Speaking to Digital Health News Babylon’s managing director of NHS services, Paul Bate, said “formal talks” were underway between the digital-first provider and Hammersmith and Fulham CCG, where GP at Hand is registered.

The service is expected to be operating in the northern city in early 2020. A new physical premises will be set up in central Manchester should the expansion go ahead, but a location is yet to be confirmed.

It comes after GP at Hand was given the green light to expand to Birmingham in June, with a number of restrictions in place including a limit to patient numbers and registrations within the Birmingham and Solihull area only.

Bate said the provider did not expect the same restrictions to be placed on its Manchester expansion owing to the fact that initial concerns, including access to screening services, had been ironed out.

“Restrictions were very specific to the ODS (Organisation Data Service) codes, which we’ve been told is now solved,” he said.

“We would hope that means the restrictions that we initially had might not be put in place.”

The ODS working group was established in June to manage GP at Hand’s expansion to Birmingham.

The group outlined a number of requirements for Babylon to achieve before initial limits on patient numbers could be lifted, including configuration to national screening systems and process as part of its expansion requirements.

Last week Digital Health News reported that GP at Hand’s expansion to Birmingham had been delayed due to Hammersmith and Fulham CCG missing a deadline to upgrade its referral software.

The CCG agreed to upgrade a key piece of software at its August primary care commissioning committee (PCCC) meeting, with the intention of completing the work by the 17 September meeting. It’s now been delayed to the 8 October meeting.

The provider confirmed it had adhered to the requirements and was now waiting for the CCG to upgrade its software.

GP at Hand will also be required to set up a new alternative provider medical services (APMS) in Manchester after NHS England approved changes to out-of-area patient registration rules meaning digital providers would have their contracts disaggregated once they reach a threshold of 1,000 patients.

The verdict means Babylon, which has currently registered about 60,000 patients at Hammersmith and Fulham CCG, will have to set up 17 new APMS, some of which will require new physical premises.

All patients registering in Manchester will be looked after by Hammersmith and Fulham CCG.

GP at Hand’s expansion across the country has caused concern for some, particularly around the issue of funding for the CCG.

MP for Hammersmith, Andy Slaughter, has previously 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, following previous “serious concerns” about the more than £20m funding deficit the GP at Hand had caused the CCG.