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Choose and Book? Choose another one!

GPs should not commission services from hospitals that insist referrals are made through Choose and Book, the GPC has advised.

When hospitals refuse to accept a booking through alternative means, GPs should instead give the work to other providers.

The advice follows moves in some areas to send back referrals made not using the Choose and Book software.

In recent weeks, Milton Keynes PCT has signalled that it would be ceasing managing referrals, and that referral letters faxed or sent directly to Milton Keynes district general hospital would be sent back.

The only exceptions would be a small number of specialties where referrals cannot currently be made using Choose and Book.

Bedford Hospital also confirmed that it is rejecting referrals not made using Choose and Book for ENT.

But Dr Richard Vautrey, GPC negotiator, warned that the action was 'inappropriate' and said the GPC was 'exploring the legal issues' behind the hospital trust's moves. 'GPs have a duty to make a referral when appropriate. The method with which they do that shouldn't determine whether a hospital accepts referrals or not,' he said.

Dr Vautrey said hospitals must accept that there may be a variety of reasons why a Choose and Book referral was inappropriate.

'These sorts of dogmatic diktats always lead to potential problems because there are always exceptions to the rule. While it's up to the patient to decide, if practices are struggling to make a referral to a particular hospital it means they're going to look elsewhere,' he said.

Dr Paul Roblin, chief executive of Thames Valley LMCs, said: 'If Choose and Book isn't fit for purpose, making it the only way to refer is absolute lunacy. You have to have a fall back. When Choose and Book is fit for purpose, it might be appropriate but it certainly isn't at the moment.'

Salford PCT announced plans to restrict referrals to Choose and Book last year (Pulse, 21 September) but Dr Nigel Hyams, Salford and Trafford LMC vice-chair, said the PCT had backed down after LMC pressure.

It is now asking GPs to fill in a form when a non-Choose and Book referral is made in a bid to discover the extent of problems with the scheme.

GPC stance

• GPs should not commission hospitals which insist on Choose and Book referrals unless the patient insists

• GPC is seeking advice on whether hospitals can legally block referrals outside of Choose and Book

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