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Hospitals abusing Choose and Book to bend rules

PCTs and hospital trusts are manipulating Choose and Book to manage referrals and hit waiting list targets, a Pulse survey has found.

One in five GPs is being forced by trusts to make all referrals through Choose and Book, and 61% believe it is being used by PCTs as a referral management system.

More than half of respondents say they are unable to refer to a named consultant through Choose and Book, and 45% say they are being blocked from referring to a hospital at risk of missing its 13-week waiting time target.More than two-thirds say they do not feel Choose and Book has been a useful addition to GPs' referral resources.

The poll of 398 GPs, carried out on behalf of Pulse by doctors' mobile communications firm Pearl Medical, paints a detailed picture of the problems GPs attempting to use Choose and Book are facing, and follows fierce criticism of the system at last week's LMCs conference.The Pulse Common Sense on IT Campaign is calling for Choose and Book to be scrapped in its current form along with closer controls on patient records.

Dr Andrew Mimnagh, chair of Sefton LMC and proposer of a motion declaring the system 'unfit for purpose', said: 'Choice is not the problem in the health service – and it's certainly not the answer.

'He said he had heard of cases from across England where PCTs had used Choose and Book to manage their referrals, particularly by 'greying out' referral slots at hospitals struggling to meet waiting list targets. 'In some areas, you may have perfect choice in your electronic systems. In others, you find providers in danger of not reaching the wait simply disappear.

'Dr Paul Cundy, chair of the GPC IT subcommittee, said: 'Ignoring the technical problems and the workflow problems with Choose and Book, it's a fairly obvious problem that a centrally imposed and centrally controlled electronic booking system that everyone is encouraged to use can be used for political manipulation.

'Dr Giles Bointon, a GP in Chipping Camden in Gloucestershire, said his practice stopped using Choose and Book in April after using it for a year.

'Despite using Choose and Book exclusively, my referral pattern didn't change one iota from pre-Choose and Book – they wanted to see the local consultants I recommended. Having ditched it, it's like having shackles taken off your legs.'

A spokesperson for Connecting for Health said that many of the issues raised by the survey occurred because of 'inappropriate' use by local trusts.'In instances where this is apparent, action is taken with the SHA,' he said.

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