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'104% of practices using Choose and Book.' So how's that then?

Every PCT has staff members whose job description includes that unenviable task – get GPs using Choose and Book.

By Steve Nowottny

Every PCT has staff members whose job description includes that unenviable task – get GPs using Choose and Book.

It's a thankless chore – so credit where credit's due to managers at NHS Nottingham City, NHS Stoke-on-Trent, NHS Heywood, Middleton and Rochdale, NHS South Gloucestershire, NHS East Lancashire and Northamptonshire Teaching PCT. Not only have they got every GP practice in their area using the controversial system – in a Herculean effort they've somehow all managed to exceed 100% take-up.

Check out the latest practice uptake figures released by the Department of Health. In December 2008, the most recent month for which figures are available, all of the above PCTs apparently reported that more practices had used Choose and Book than there actually were practices in the area. In South Gloucestershire, a record 104% of practices used Choose and Book in December.

What an incredible, Stakhanovite effort. Expect outbreaks of unbearable smugness in certain PCT managers' appraisals in the near future.

Of course, if you look at the small print, there is an explanation. ‘'Percentages over 100% may occur when the denominator understates the total number of GP practices in the PCT at the time,' we are told.

Which makes sense. But consistent reports of more than 100% takeup don't do much to reassure GPs or patients about the statistics used to mark Choose and Book progress. (Another question – has Darlington PCT really had consistent 100% takeup of Choose and Book ever since April 2006, when they first started calculating the figures, or did they just forget to fill in the form?)

In fact, the table on practice take-up figures as a whole is rather misleading, as it counts a practice as using the system even if just one GP uses it for one referral in the whole month.

If you want to get a better sense of the extent to which Choose and Book is being used in your PCT, look instead at a second table released by the Department of Health, which sets out the percentage of GP referrals to first outpatient appointments made using Choose and Book.

Here takeup in December ranged from a reported 100% in Wiltshire to just 12% in Barnet. 83 trusts have less than 50% takeup.

This may or may not be the table those unfortunate PCT managers choose to use when it comes to appraisal time.

Choose and Book: How come 104% of practices can be using it in some areas? Choose and Book: How come 104% of practices can be using it in some areas? Recent posts

QOF and MPIG changes: what your PCT is doing March 3
GPC's exaggerated claims on QOF losers starting to pay dividends February 27
Extended hours? You must be joking... February 25
Should GMC have spent £43,000 on Cape Town junket? Feburary 20
Pay survey by next week? MPIGs might fly... February 18
Lord Darzi, GQ superstar February 13
Why GPs will no longer have a choice over Choice February 12
The strange contenders for the world's best GP job February 11
When is a consultation not a consultation? When it's on polyclinics February 10
What would you ask Alan Johnson February 05
Choose and Book: we told you so February 04
Is the straight white male GP really an endangered species? February 02
Preparing for power 30 January
Profits drop not the only story from GP survey January 29
Choose and Book: Two steps back, one step forward January 26
Lord Darzi's secret meeting with the private sector January 22
The best GP job in the world? January 21
Can Barack Obama revive general practice? January 20

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