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Gold, incentives and meh

Leaders defend IT program

I am shocked by Pulse's campaign calling for a halt to Choose and Book. Your campaign is based on a series of inaccurate statements and comes at a time when the NHS is making considerable progress in using Choose and Book – approximately 40% of referrals are now being made through the system.

Your maths just do not add up. The figures you quote confuse the original PCT Capital Incentive payments that were allocated by the Department of Health, with the money that was actually paid to those who met the incentive targets. To run a headline claiming that Choose and Book is costing the taxpayer £210m is therefore misleading.

Additionally, a referral through Choose and Book does not cost £25. When Choose and Book is fully utilised the expectation is the cost per referral will be less than £1.

Your call to halt Choose and Book completely overlooks the wide range of benefits it has already brought to patients and the NHS. Contrary to wasting taxpayers' money, trusts are reporting that Choose and Book is enabling them to achieve significant savings.

To imply that medical data can get lost through Choose and Book is also misleading. It doesn't. To date, the national Choose and Book team has had no record nor received any evidence of patient records and referrals going missing through the Choose and Book system.

Choose and Book is a big step towards giving patients greater involvement in the decisions about their treatment. To put a halt to Choose and Book would deny millions more patients the right to choose where and when they want to be treated and take us back to the chaos and confusion of longer waiting times and lost appointments.

From Dr Mark Davies, medical director, Choose and Book, Connecting for Health

Editor's note: The figures Pulse gave for the projected cost of Choose and Book were obtained from the Department of Health. We were careful to set out separate numbers for the amount allocated by the department for implementation and the amount that has so far been spent. Our estimate of £25 per booking was made using the number of bookings and amount spent so far. The cost of bookings may well come down to under £1 once the system is fully utilised, but with only 38% of bookings currently going through Choose and Book, that point is still some way off.

I must register my disagreement with your latest campaign on Choose and Book and the National Care Record.

In our practice we all use Choose and Book for all the referrals that are available on the system (we're still waiting for some, such as two-week waits, which is very frustrating). Yes, it does still seem a bit clunky at times, but it's a whole lot better than snail mail.

We like to offer our patients choice as it involves them in the decision and surely that's right as it's the patient who is being referred for their illness not me.

Our patients like it and we like it, so what's all the whinging about?

Sure, we'd like slicker log-on and better integration with our clinical system, but that's no reason to say we don't want Choose and Book.

As for shared electronic records – yes please, the sooner the better. Of course the security has to be good – better than sending a letter in the post (not difficult!).

Every day we are faced with clinical risks directly attributable to poor communication between secondary and primary care (for example, no letter sent). If only we had access to a shared record – it's certainly what I would want as a patient.

Ask most patients and they are amazed that we don't have a single shared record already, just as they thought it unbelievable that we still sent referral letters through the post.

From Dr Stephen Earwicker, Stapleford, Nottingham

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