GP leaders welcomed the NHS Plan published yesterday – but practices are set to find themselves facing some challenges.

The plan proposes to allow patients to switch to “digital only” practices, apparently endorsing the controversial Babylon Health model that has been opposed by NHS England and senior GPs but backed by health secretary Matt Hancock, it emerged.

It will also require practices to sign new “networks,” binding them to working with other practices for populations of up to 50,000 patients.

However NHS England has successfully side-stepped controversy about privatisation – and has asked the government to amend its controversial 2012 NHS legislation.

The amendments would reduce the pressure for clinical commissioning groups and other NHS bodies from putting services out to tender – and stop competition authorities intervening in tendering or in mergers of organisations.

They would also allow the creation of integrated care systems, which campaigners have claimed could allow back-door privatisation. ICS organisations could run secondary and primary services and even other care services.

Prime Minister Theresa May, launching the Plan yesterday, said: “I want to see the NHS make greater use of technology. Not only to make healthcare safer and more effective, but to make the most the exciting new possibilities and give you greater control over your own care.

“And that means everything from monitoring conditions from the comfort of your home to accessing your GP by your smartphone.”

Royal College of GPs chair Professor Helen Stokes-Lampard said: “GPs are open to working differently in the best interests of patient care, and we know that working in larger groupings can be beneficial in terms of increased peer support, building resilience in the system and working more collaboratively – and primary care networks build on models that have been shown to be successful. However, it is vital that this is done in a way that minimises disruption for hard pressed GPs and their practices and enables progress to be made in a way that protects the ability of GPs to deliver care in the way that best meets the needs of their local communities.

“It is also vital that continuity of patient care is prioritised.

“The emphasis on widening choice for patients using digital means to consult with GPs is interesting and will be very attractive to some patient groups. However, the three tests specified to ensure patient safety, NHS stability and fairness must be applied properly before new schemes are rolled out further.”

The British Medical Association urged the Government to respond swiftly to deliver the requested legislative changes.

BMA chair Dr Chaand Nagpaul said: “Clinical Commissioning Groups should have the flexibility to commission services to suit local need, not to suit competitive tendering regulation and without the fear of having to pay out millions to private providers for falling foul of existing legislation, as has been the case in recent years.

“When Government rhetoric is centred around integration within the health service, independent providers bidding on time-limited contracts sits entirely at odds with this philosophy. Only by removing the requirement to put service out to tender, can local systems work together to ensure cohesive patient-centred healthcare.”

Dr Peter Swinyard, chair of the Family Doctor Association, said the effect of the plan would be to re-create primary care teams, in which midwives and district nurses work with GPs.

He said: “In recent years, the loss of this communication, along with the reduction in numbers of fully trained district nurses, has severely impacted on the co-ordination and efficiency of patient care. This primary care team has been given a 2019 rebrand – renamed a multidisciplinary team and placed at Primary Care Network level but its re-formation is greatly welcomed.”