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Independents' Day

Exclusive: PCTs spending millions to prop up Choose and Book

By Steve Nowottny

Fears that thousands of GPs are getting ready to dump Choose and Book have prompted PCTs to plough millions of pounds of their funding into local incentives to try to salvage the controversial system.

A Pulse survey this week finds that seven out of ten trusts are considering a Local Enhanced Service next year, with most of the rest still undecided. Just three of the 35 PCTs surveyed said they had decided not to set up a LES.

The much-criticised Choose and Book system achieved a major milestone this month with GPs using it for the first time for more than 50% of first outpatient referrals and more than six million patients have now been referred through the system.

But Government IT bosses and PCTs admit they have major fears that usage will drop when Choose and Book funding is switched to extended hours at the end of March.

A spokesman for East Sussex Downs and Weald PCT, where GPs currently only refer 30% of patients through Choose and Book, said it had guaranteed to fund a LES next year. ‘Many practices have indicated they would cease to support Choose and Book without financial support,' he said.

A spokesman for Lewisham PCT added: ‘The plan to stop the DES has had a negative impact - although this follows the view that the DES never recompensed the practice for the work required to deliver Choose and Book anyway.'

According to the BMA's GP Opinion Survey, published at the end of last year, one in eight GPs stopped using Choose and Book in April 2007, amid fears financial incentives would end when the Choice and Booking DES was not renewed for nearly two months.

But Dr Gurmit Mahay, secretary of Wolverhampton LMC, warned that the impact this year, with the DES guaranteed to end, was likely to be far more severe.

‘A straw poll in Wolverhampton revealed that 80% of GPs would be likely to give up Choose and Book,' he said. ‘A LES is not yet on the table – if one were offered, depending on the terms it is likely to shore up Choose and Book activity.'

Choose and Book medical director Dr Stephen Miller said it was ‘difficult to envisage' what impact the end of national incentives would have, and said last year there had been a ‘plateau'.

‘In April there will be new Choose and Book enhancements to support the full rollout of Choice, where the majority of patients being referred to secondary care can choose where they want to be treated,' he said. ‘I really hope that these enhancements will sustain continued interest.'

PCT funding to save Choose and Book

- 24% already offering LES on top of DES

- 46% will offer a LES next year

- 29% considering offering a LES

- 16% undecided

- 9% won't offer a DES

Source: Pulse survey of 35 PCTs

Dr Stephen Miller: difficult to envisage the effect ending Choose and Book incentives would have Dr Stephen Miller

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