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Forgetful patients may cost GPs Choose and Book pay

GPs are in danger of missing out on enhanced service pay because patients do not remember discussing a choice of hospital during their consultation, writes Ian Cameron.

Data from a Department of Health survey conducted last month, obtained by Pulse, shows only 30 per cent of patients recalled being offered choice by their GP.

Yet in at least three areas, the local result was well below the number of patients either referred by GPs via Choose and Book or given leaflets on choice by their doctor.

GPs can earn 24p per patient under the choice and booking directed enhanced service for discussing choice with patients.

But 60 per cent of patients must recall the conversation in a national patient survey for GPs to get the money.

Board papers from North East Lincolnshire PCT reveal that of 259 patients who had been referred, only 35 per cent recalled having been offered a choice of hospital.

Yet 59 per cent said they had been given a choice booklet by their GP.

The PCT described the result as 'puzzling'.

Brent LMC said its PCT had agreed to investigate after a survey showed a low level of choice being offered by GPs – in contrast to practice records.

Similarly, despite GPs in Harrow PCT being the highest users of Choose and Book in north-west London, patients' awareness of choice was lowest in the area.

Dr Ethie Kong, a GP in Brent and member of the LMC, said the result was unfair on practices.

She said: 'I know I do Choose and Book, I give patients leaflets and I Read code it, but there will be a mismatch because patients only retain 60 per cent of what you tell


'You have to keep emphasising choice as a mantra.'

Dr Chaand Nagpaul, vice-chair of Harrow LMC, said: 'If you are using Choose and Book then by definition you are offering choice, but we have to tell patients they were offered choice.'

Dr Richard Vautrey, GPC negotiator, said GPs needed to reinforce the fact a choice discussion had taken place three or four times to ensure patients recalled it.

He added there was no prospect of the Government abandoning use of patient surveys to determine GPs' pay, whatever the problems.

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