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GPs buried under trusts' workload dump

Choose and Book to become compulsory

The era of the paper referral is about to come to an end with PCTs across the country moving to make use of Choose and Book compulsory by next year, Pulse can reveal.

Half of all trusts have set in motion plans to insist that all referrals are made electronically – with tens of thousands of GPs to lose their right to refer patients using the traditional paper-based system.

The hardline approach comes as the GPC issued a blunt warning to all GPs to expect an end to the Choose and Book DES from next year.

Half of PCTs responding to a Pulse survey admitted they have discussed or are considering phasing out paper referrals. Of the 48 trusts who had responded when Pulse went to press, 24 had started action or are planning to take action, often within the next few months, to make electronic referrals mandatory.

Areas where the phasing out is already underway include Barnsley, Bedfordshire, Eastern and Coastal Kent, East Sussex Downs and Wield, Heywood, Middleton and Rochdale, Medway and Southampton City.

Some areas have warned that in future any paper referrals will be returned unprocessed.

Bradford and Airedale PCT told Pulse it planned to phase out all paper referrals as part of ‘working towards the March 2008 national target'.

But Choose and Book medical director Dr Stephen Miller denied PCTs were working to national targets, and insisted Connecting for Health would not support GPs being forced to use Choose and Book.

‘There's no such target,' he said. ‘There have been paperless pilots that have been quite successful from what I've heard, but we don't support the mandated use.'

Dr James Gilgrass, chief executive of Surrey and Sussex LMCs, said it was ‘absolutely against' plans in East Sussex Downs and Weald and Hastings and Rother to phase out all referrals by early next year.

‘GPs are very angry that paper referrals will stopped,' he said.

The LMC last week assisted a GP whose paper referral had been returned, he added.

‘We sent the message back loud and clear that the Trust had no right to refuse a paper referral.'

In Salford, where negotiations with the LMC are ongo-ing, the PCT said it hoped to phase out referrals ‘at some time in 2008.'

Dr Ravi Mene, secretary of Salford and Trafford LMC, said: ‘We have put our foot down to say that this is not acceptable. Freedom of referral should be there for GPs in whatever form.'

Dr Paul Cundy, chair of the joint RCGP and GPC IT committee, said: ‘PCTs cannot enforce Choose and Book as the only mechanism for referral. If they do, the PCT is liable for the consequences of those actions.'

But Dr Alan Keith, a GP in Rotherham, said he did not object to Rotherham PCT's plans to move to Choose and Book-only referrals.

‘We're using it pretty much 100% now and it's going really well,' he said. ‘I can't understand why other GPs are having a bad experience with it – I tend to think it's a problem between chair and keyboard to be honest.'


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