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Choose and Book target scrapped

By Alisdair Stirling

Exclusive: The Government has quietly dropped its long-standing target of channelling 90% of GP referrals through Choose and Book, Pulse can reveal.

The move - which signals an end to the centrally-led drive to boost Choose and Book uptake - follows evidence that the programme had stalled with usage at little more than 50% and mounting frustration among GPs attempting to meet the 90% target.

The announcement came in the small print of the Department of Health's Technical Guidance for the 2011/12 Operating Framework, released last week.

The guidance states: ‘Historically, the ambition was to achieve 90% of GP referrals to first outpatient appointments being made using CAB. Although there is no longer a target for CAB utilisation, this figure may serve as a useful guide for judging success.'

The DH has also revealed for the first time the proportion of Choose and Book referrals permitting referral to a named consultant, with the inability to do this a frequent bugbear among GPs using the system.

A spokesperson told Pulse: ‘Nationally, in December 2010 an average 41% of Choose and Book bookings were to services which had at least one clinician named against them.'

However the DH guidance makes it clear that hospitals will be expected to rapidly improve on this proportion, stating: ‘All patients should have the opportunity to choose a named clinician for first outpatient appointment from April 2011, even if they do not wish to take that opportunity.'

Choose and Book survived the £700 million IT projects cuts in September last year after the Government hailed it as ‘successful'.

But a Pulse investigation revealed usage had stalled and even fallen in 2010, with 53% of all GP referrals to first outpatient appointments booked through the system in June 2010 - the same as in June 2009, and down from 56% the previous October.

Dr Andrew Mimnagh, chair of Sefton LMC, said scrapping the target was ‘a very good idea'.

'The reality is hospitals just aren´t geared up for it,' he said. ‘There are reports that they print Choose and Book bookings off and pass them round by hand. We're nowhere near 90% in our area.'

'GPs are very computer literate and data friendly so there's no problem at our end. The whole thing would be great if hospitals actually honoured the appointments they find on Choose and Book - but they don't.'

The DH has indicated that GP consortia should maintain and invest in the system as they take over from PCTs and this week backed the system in spite of dropping the 90% target.

‘The Choose and Book system is giving patients much greater involvement in the decisions about their healthcare and will continue to be an important element in helping to make choice a reality,' a DH spokesperson said.

Choose and Book referral targets scrapped