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Independents' Day

Choice of hospital exposed as a sham

GPs blocked from making Choose and Book appointments to ensure wait targets are met

Patients are being denied treatment at their chosen hospital to ensure Government waiting targets are not breached.

A Pulse inquiry has uncovered numerous examples of PCTs deleting popular hospitals from the menu of choices available to GPs using Choose and Book to ensure no patient waits longer than 13 weeks.

The move has left GPs increasingly unable to book slots at patients' preferred hospital, forcing people to travel long distances to less popular clinics even when they would prefer to wait longer.

The revelation makes a mockery of the Government's promise to give patients free choice of where they are treated and reveals waiting times are its real priority.

The clinician in charge of Choose and Book has even revealed PCT chief executives could be at risk of the sack if they allowed patients to book slots past 13 weeks.

Dr Mark Davies, clinical lead for Choose and Book at Connecting for Health, said the system allowed slots to be booked up to 180 days ahead – but commissioners had the power to take hospitals off menus if they could not offer a booking inside the 13-week target.

He said: 'It would be unusual for any chief executive that wants to remain in post to

release slots that can be booked past 13 weeks.'

Professor Mike Pringle, national GP clinical lead for Connecting for Health, said it was aware of concerns and would be redesigning Choose and Book.

The restrictions have emerged as use of Choose and Book by GPs has grown.

And they are expected to worsen as take-up increases further and when waiting targets fall to 11 weeks in March 2007.

Dr Nigel Watson, chief executive of Wessex LMCs, said 10 per cent of referrals in some areas were affected. He said: 'Patients say they are willing to wait longer to go somewhere local. The whole thing is ludicrous.'

Dr Paul Roblin, medical

secretary of Berkshire, Buckinghamshire and Oxfordshire LMCs, said GPs in Milton Keynes were being forced to refer to Birmingham or Oxford.

Dr Rob Barnett, secretary of Liverpool LMC, said ENT slots at Royal Liverpool hospital and orthopaedics at Aintree hospital had 'suddenly disappeared'. He said: 'There's no honesty in the system.'

A Department of Health spokeswoman said patients should be able to choose a hospital, even if the appointment had to be outside 13 weeks. GPs should make a manual referral if Choose and Book did not offer a 13-week booking, she added.

Where choice is being restricted

Area Specialty where

choice restricted

Bristol Orthopaedics

Cornwall ENT and cardiology

Exeter Orthopaedics

Leeds Foot and ankle surgery

Liverpool ENT and orthopaedics


Keynes Various

Swanage ENT and orthopaedics

'Intellectual corruption'

Dr Michael Caruana says bookings in at least two or three specialties at his local community hospital are blocked each week to ensure 13 week waits are met.

Dr Caruana, GP and medical director of Swanage Community Hospital in Dorset, says slots cease to be bookable beyond eight weeks, particularly for ENT and orthopaedics, if there is 'any threat' to the 13-week target.

Patients – often elderly – are forced to travel 15 or 20 miles to Wimborne or Dorchester instead.

'Choose and Book has distorted referrals dramatically,' he said. 'If money followed the patient the PCT would set up extra clinics. It's another example of intellectual corruption in the NHS.'

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