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Not a single primary care trust is expected to meet the next Department of Health target for Choose and Book.

The second stage of a three-stage incentive scheme would have rewarded each PCT with £100,000 if 50 per cent of GP referrals are made via the system by the end of October.

But only slightly more than 8,000 referrals have been made via the system across the whole country so far.

Dr Alan Hassey, chair of the RCGP's health informatics group and co-chair of the joint RCGP/BMA IT committee, confirmed reports that the department had contacted strategic health authorities to say there was no change to the target despite the prospect that no PCT will meet it.

‘I've heard it from health authority sources and I believe it to be true,' said Dr Hassey. ‘I don't think it's come as a surprise.'

Dr Gillian Braunold, GP clinical lead for Choose and Book, admitted its targets were ‘challenging' but refused to comment on whether PCTs would meet it.

‘This is a very hard and complex set of things put together,' she said. ‘It's hard enough to do either separately but it's going to take off in a big way.'

The department refused to say whether PCTs would still qualify for the extra cash once they met the target.

Dr Paul Cundy, chair of the GPC's IT subcommittee, said the project had yet to overcome two fundamental problems: GPs expect to be paid for participating, and do not believe the software is efficient enough.

‘It's not just a question about incentives to get it going but the fact it's new work, which according to the new GP contract needs to be funded,' he said. ‘And we've got to have the right tools to do the job.'

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