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GPs fight to save enhanced services cash

The National Audit Office condemns the Government over e-booking as GPs step up their fight to choose their own IT system ­ Joe Lepper reports

The Government's flagship electronic booking scheme is failing because of chronic technical problems and a lack of support from GPs, a scathing report by public spending watchdogs concludes.

The National Audit Office revealed just 63 hospital referrals had been made by GPs trialling the Choose and Book scheme by the end of 2004, compared with a target of 205,000.

Its report also attacked the Department of Health for failing to communicate with GPs about the scheme and convince them of its merits.

A survey of 1,500 GPs by the NAO found almost 60 per cent were 'negative' about Choose and Book and 90 per cent thought it would increase their workload.

Chris Shapcott, director of health value for money studies at the NAO, said the policy 'will not be deliverable without a higher level of support by GPs'.

Government plans are for all 9.4 million hospital referrals to be booked via Choose and Book by the end of 2005, with 70 per cent done online by GPs during consultations.

But GPs have scorned ministers' claims that giving patients a choice of five hospitals and booking the appointment will only add a minute to a consultation.

Many have refused to take part in Choose and Book unless they are paid extra to compensate for the added time.

Dr Paul Cundy, GPC IT sub-committee chair, said the National Programme for IT, which is in charge of the scheme, had 'fallen into every elephant trap that's available'.

He said: 'NPfIT has made every single error that could possibly have been made. Their failure eclipses all previous IT failures and has to raise questions about competence at the highest levels.'

Major technical problems identified by the audit office centre on the lack of cohesion between hospital and practice IT systems and with national NHS computer infrastructure.

Hospitals and PCTs are also ill-prepared for the scheme. Just seven hospitals were linked to the system by the end of last year, well short of the Government's target of 22.

A quarter of PCTs said they would fail to achieve targets to implement Chooise and Book and two-thirds were not yet commissioning the required number of providers.

Health Secretary John Reid said the low number of bookings so far was because the Government had decided to 'road test' the system with a 'small number of people'.

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