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QOF problems? Stop moving the goalposts

By Ian Cameron

GPs must still offer patients a choice of hospitals even if their Choose and Book IT system does not work properly.

Folders of information are to be sent to practices by

PCTs to ensure they meet a Government target to ‘manually' offer a choice of at least

four hospitals by the end of


The folders supposedly contain all the hospital data GPs need to offer choice even if their computers cannot interface properly with hospital IT.

A Department of Health letter which revealed the plan to strategic health authorities said a fifth of referrals may need to be done manually.

Dr Gillian Braunold, one of two GP clinical leads, said the move was designed to ensure the choice agenda could still be delivered. ‘IT is a tool to deliver Government priorities,' she said. ‘If it's taking a while to use that kind of tool we must provide another means to do it.'

Ewan Davies, chair of the British Computer Society's primary health care specialist group, described the move as a ‘political fig-leaf'.

He said: ‘It's not encouraging. It's not practical for GPs to work from looseleaf folders or to maintain them accurately – you can't do it without IT.'

GPs said the tack made a mockery of the high-tech flagship Government project.

Dr Andy Paton, a GP in Brixham, Devon, who blasted Choose and Book at this year's LMC conference, said a manual system undermined the idea behind Choose and Book.

‘It's a retrograde step. It's the logistics,' he added.

Dr Francesca Lasman, a GP in Huntingdon, Cambridgeshire, who quit a PCT IT job over Choose and Book, said she was yet to be convinced of the merits of offering choice as most patients asked GPs for a recommendation.

‘Giving GPs a folder does not get round that problem,' she said.

‘People need to be convinced Choose and Book will work quickly and efficiently. '

Dr Andrew Green, chair of East Yorkshire and Northern Lincolnshire LMCs, said reluctant practices would not be won over with a paper system.

He added that battles over responsibility for Choose and Book IT systems were on the horizon. ‘They are designed to work in air-conditioned rooms,' Dr Green added.

‘Very few practices have them. If you have to install it, it will be expensive.'

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