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Choice plan starts with crash

Choose and Book IT systems were down for almost the entire first day GPs were meant to offer patients a choice of four hospitals, write Ian Cameron and Sarah Gaines.

Thousands of GPs with the software were unable to use it for nine hours on 3 January because of problems with hardware infrastructure.

The crash followed intermittent problems which had left GPs unable to access patient demographic information and generate patient passwords since 19 December.

The trouble contributed to a nightmare launch of the choice initiative, with delays in sending out patient information leaflets and PCT apathy also embarrassing ministers.

Dr Gillian Braunold, GP clinical lead at Connecting for Health, said she had been among GPs affected by the Choose and Book 'outage'.

She said: 'I was jumping up and down. What's important is to learn from what happened ­ both in terms of why and the quality of communication.'

But GPs said their confidence in the system had been dented, particularly as it was handling only a fraction of the intended number of bookings.

Dr David Bevan, a GP in Upwell, Cambridgeshire, who resigned as a local choice lead, said the resilience of Choose and Book was in doubt. He said: 'When I stopped being a choice apparatchik my partners said why are you not using it. I said ''You'll see''.'

Dr Paul Cundy, chair of the GPC's IT subcommittee, said: 'If it can't work with current workload there's no way it will with widespread use of GP-to-GP records transfer and electronic transfer of prescriptions.'

As well as the problems with Choose and Book, millions of leaflets giving patients information about hospitals have been delayed.

At least one PCT has also indicated GPs can evade having to offer choice.

A letter from the chief executive of Mid and South Buckinghamshire PCT told GPs to mark all referrals 'choice offered', and added 'auditing and policing of compliance will be difficult'.

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