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Independents' Day

Choose and Book fails to achieve key targets

By Steve Nowottny

Choose and Book has failed to win over GPs and is ‘struggling to deliver' on patient choice, a damning report from the Healthcare Commission warns.

The commission's annual health check found only 2% of PCTs hit targets on convenience and choice – a result described as ‘by far the worst level of performance for any of the existing national targets'.

‘The challenge of persuading independent practitioners to adopt the new system has been far harder than anticipated,' the report said.

Meanwhile, new figures from the Government's bimonthly tracking poll on patient choice showed a fall for the first time in the number of patients who recalled being offered a choice of hospital.

The latest National Patient Choice Survey found 44% of patients recalled being offered a choice for their first outpatient appointment in May, down from 48% in March.

A Connecting for Health spokesperson admitted encouraging GPs to use Choose and Book had been ‘a key challenge' but insisted the programme was ‘here to stay'.

He added that 43% of first outpatient referrals were now made through Choose and Book.

BMA chair Dr Hamish Meldrum said there was a lot of evidence to show imposed referral management schemes and problems with the Choose and Book IT system had worked against patient choice.

‘The BMA has urged the Government time and time again to work with doctors before rolling out expensive software systems, but unfortunately this has not happened,' he said.

As details of the scheme's poor performance emerged, Peterborough PCT become the latest trust to refuse to accept paper referrals from GPs.

A PCT spokesperson confirmed mandatory use of Choose and Book would be phased in next year.

Pulse last week revealed that Eastern and Coastal Kent PCT is due to begin phasing out paper referrals in December.

Dr Rob Sadler, chair of Kent LMC, said the decision had caused ‘significant disquiet' among local GPs, many of whom have doubts over Choose and Book.

‘Some doctors in East Kent have not engaged at all with Choose and Book because of the workload issue,' he said.

‘We have all these issues which haven't been properly thought through before imposing these arbitrary deadlines.'

The Healthcare Commission blamed poor progress on the lack of contractual obligations on GPs to use the system, teething problems with the system itself and patient unfamiliarity with the concept of being offered choice.

Cash fears halt use of system

One in eight GPs stopped using Choose and Book this year amid fears financial incentives would end, a BMA survey has revealed.
The Choice and Booking DES expired at the end of March this year, and was not renewed for nearly two months, leading to fears GPs would no longer be paid for offering choice.
According to the BMA's GP opinion survey, published last week, 12% of GPs dropped the system between April and June.
The future of next year's DES was queried last week after a Connecting for Health official suggested demand from patients would replace financial incentives as the main motivation for using the system.
But Dr Andrew Mimnagh, chair of Sefton LMC, said: ‘Without any remuneration we'll find it a bit of a burden. I think the profession as a whole is sceptical of the attempt to influence it by the sort of pester power the Government's encouraging.'

Dr Andrew Mimnagh: GPs will find Choose and Book a burden if incentives are scrapped Dr Andrew Mimnagh: GPs will find Choose and Book a burden if incentives are scrapped

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