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Choose and Book setback

Most practices are certain to miss the June target to make a quarter of their referrals via Choose and Book, writes Ian Cameron.

The failure means thousands of practices that have signed up to the Choose and Book directed enhanced service will have the 24p per patient aspiration money clawed back by PCTs.

GPs said they had been frustrated in their efforts to hit the target by difficulties with the software and problems linking to hospital systems.

LMCs said many local hospitals had not put enough clinics or appointments on to the directory of services, preventing GPs making bookings.

The problems have led LMCs and the GPC to call on PCTs to use flexibility available in the enhanced service specification to delay when they judge GPs' achievement.

If GPs are willing to use Choose and Book but are physically unable to make the required number of referrals via the system, PCTs can use their discretion and allow GPs to keep the money.

The aspiration payment is worth around £1,500 to an average practice.

Dr James Gilgrass, secretary of Surrey and Sussex LMCs, said there was 'absolutely no way' practices in the region would get close to 25 per cent.

He said: 'It's hardware, software and problems with appointments. Not everyone even has smartcards.'

Dr George Rae, secretary of Newcastle and North Tyneside LMC, said: 'There are some referrals going through but probably in single [percentage] figures.'

In a letter to Connecting for Health's London cluster, Londonwide LMCs said the June target was 'impossible' and demanded the Department of Health and the National Programme for IT review it.

Dr Richard Vautrey, Leeds LMC secretary and GPC negotiator, said measurement had to be in June, but PCTs had flexbility on what basis they judged GPs' achievement.

He said he was in discussions with PCTs about solutions, such as basing the aspiration payment on GPs having made 25 per cent of referrals that could possibly have been made using Choose and Book on the system.

'If there are legitimate reasons then that's reasonable.'

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