NHS GP app under fire over Cummings links and chest pain diagnosis

The NHS-backed virtual GP app Babylon Health is no stranger to controversy – nearly two years ago it emerged that it had tried and failed to gain a legal injunction to block publication of a damning report from the NHS care standards watchdog.

But now the digital service, also backed by health secretary Matt Hancock, is facing conflict of interest accusations over a consultancy job with Boris Johnson’s most senior aide, Dominic Cummings.

According to the Guardian, Cummings, who was famously campaign director of Vote Leave during the 2016 referendum, advised Babylon Health on its communications strategy at a time when the company looks set to benefit from public funding.

In a separate development, the app dubbed GP at Hand was criticised by doctors for giving different diagnoses for men and women suffering from the same chest pain symptoms.

The conflict of interest concerns emerged because Babylon could receive a share of a new flagship public fund to boost the use of AI in the NHS.

A Guardian/Bureau of Investigative Journalism investigation found that Cummings continued to advise the firm about recruitment until September 2018, even though his formal role ended in July last year.

In September Hancock visited the firm and told staff he wanted the NHS to help it to expand, weeks after it raised $550 million in a funding round led by Saudi Arabia’s sovereign wealth fund.

The Guardian stressed that the government money has not yet been allocated, but noted that Babylon welcomed the announcement in August of the £250 million AI fund, and is “well placed to benefit” as a key player in the field.

Babylon already has a contract with Hammersmith and Fulham clinical commissioning group (CCG) in West London, and is set to be introduced in Birmingham this month, and in Manchester in 2020.

A Babylon spokesperson said: “In July 2018, Mr Cummings carried out a very short, one-off piece of consultancy work advising on our communications strategy.

“This piece of work was completed in 10 days and happened a full year before he was appointed by Government. Our mission is to give accessible, affordable healthcare to everyone on the planet and we wanted an external view of our communications plans. We were also looking to appoint a PR Director and Mr Cummings was involved in the recruitment process on a couple of days in September 2018, but no-one was appointed.”

Differing diagnoses

The under-fire app has also been criticised by doctors for giving out differing diagnoses for men and women with the same symptoms.

The Times reported that doctors found its algorithm gave advice to a 60-year old female smoker reporting a sudden onset of chest pain, saying the probable cause is a panic attack or pain caused by inflammation.

However a 60 year-old male smoker with the same symptoms is told that he may be having a heart attack.

The man is advised to go to A&E, while the woman is told to contact her GP within six hours if the symptoms persist.

Paul Leeson, professor of cardiovascular medicine at Oxford University, told The Times that the Babylon results were a concern. “As a 21st-century doctor it’s quite bizarre to be going back to a 19th-century diagnosis of hysteria,” he said. “In a case like this, I would want to make sure I’m excluding heart attack first, whether the patient was male or female.”

Responding to the Times story, Babylon's chief medical officer, Mobasher Butt, said: “The Symptom Checker uses medical evidence to inform patients about the most likely causes of their symptoms, whereas a GP gives a diagnosis by focusing more on ruling out the most serious issues rather than on how likely they are. The Symptom Checker has been used over 1.5 million times and we have never had reports of a serious problem raised by a patient. It is designed by doctors, epidemiologists and experts from specific research areas and also gives information on whether the most serious potential cause of a symptom requires a visit to a hospital, GP or pharmacist."