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Matrons plan 'will not cut admissions'

Choose and Book will be compulsory for GPs wishing to take up practice-based commissioning from April

GPs who take up practice-based commissioning in April will be forced to take on Choose and Book as well.

Final guidance from the Department of Health ­ due out last Friday but delayed by internal wrangling ­ is expected to confirm the requirement.

Ministers have insisted on the link between the two policies in a desperate attempt to railroad GPs into implementing the controversial Choose and Book scheme.

But GPs said the move was 'ham-fisted' and would divert people away from practice-based commissioning.

The intention to link Choose and Book to practice-based commissioning was signalled by health minister John Hutton in a speech in December. He said it was 'fair and reasonable' for PCTs to insist that patients should be able to take advantage of electronic booking systems that connected GP surgeries to hospital admission systems.

Earlier practice-based commissioning guidance also said PCTs would be responsible

for ensuring patients were able to exercise choice. The final technical guidance is expected to make the link compulsory.

GPs who support practice-based commissioning said it would be a mistake to force practices to take on Choose and Book.

Dr James Kingsland, chair of the National Association of Primary Care, said practice-based commissioning could be a catalyst for Choose and Book but it 'would be wrong' to enforce a link.

He said: 'I hope and expect them not to be totally dependent on each other.'

Dr Mike Dixon, NHS Alliance chair and a GP in Cullompton, Devon, added: 'It might mean that some people don't do practice-based commissioning because they feel there are too many strings.'

GPC chair Dr Hamish Meldrum said it would be 'short-sighted' of the Government to put the two issues together.

He said: 'GPs will see it as a ham-fisted attempt to encourage them to go for Choose and Book, without addressing the real concerns of the profession.'

Internal disputes over the level of risk carried by practices and PCTs if spending on commissioning goes up is believed to have delayed the release of the technical guidance.

By Rob Finch

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