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GPs can only refer via Choose and Book, CCG rules



Exclusive GPs are being told that referrals to some providers will only be accepted if they are made through the Choose and Book system.

NHS Oxfordshire CCG has told practices that referrals to the musculoskeletal services at Nuffield Orthopaedic Centre and community physical and mental health services at Oxford Health NHS Foundation Trust will have to be made through Choose and Book.

The CCG is currently funding GPs to use Choose and Book, but the LMC has expressed fears that the funding will be non-recurrent.

The move has also angered some GPs who argue that the system is time consuming and diverts their attention from patient care towards administrative activity and is potentially contrary to the contract.

The uptake for the Choose and Book system has stalled at 50%, with problems around double booking of appointments and providers failing to make appointments available inhibiting more widespread use.

As a result, NHS England is set to phase out the system, to be replaced with a new ‘e-referrals’ system, which is based on airline booking systems.

It was initially due for roll-out last year, but this was pushed back to this spring, although there is no indication around when it is being rolled out.

Despite this, NHS Oxfordshire CCG and the Oxfordshire trusts have said they have had to make Choose and Book compulsory because of ‘significant problems’ with patients being able to get appointments, and that referrals are being submitted in a number of different formats.

The CCG has said it has agreed this with the LMC, but the Berkshire, Buckinghamshire and Oxfordshire LMC newsletter revealed that GPs are against the moves.

One GP pointed out: ‘There is not a contractual requirement to use Choose and Book. Some practices feel that it reduces the workload associated with the referral process whereas others report that it is time consuming and involves more work. Practices are not using Choose and Book for a reason. Remove that reason and greater use will follow.’

Another said: ‘Having to directly book appointments in the consultation is not possible without cutting corners in the consultation. We are doctors, not booking clerks.’

Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMC said: ‘Oxford University Hospitals has been slow regarding giving direct bookings.

‘Any surgery using it should be funded for backroom staff to do this. NHS Oxfordshire CCG does fund us for this, but there may come a point when it’s removed.’

He added that there was uncertainty about the legality of the move. He said: ‘If GPs went to court on it they might win on the grounds that it goes against the contract, but they could lose for deliberately deciding not to adopt it.’

Dr David Chapman, clinic lead for Choose and Book at NHS Oxfordshire CCG, said: ‘We have had significant problems with patients being unable to get appointments in a timely way.’

This had affected GPs, who were ‘undertaking a lot of extra work in chasing up appointments and reassuring worried patients’. He added that providers have had referrals submitted in several different formats, ‘making it very difficult for them to manage them in a standard way’.

Dr Chapman said: ‘In Oxfordshire 80 out of 81 GP practices use Choose and Book. We have agreed with our LMC that from 1 April 2015 providers may choose to accept referrals via Choose and Book only, unless there are exceptional circumstances when a patient or carer is unable to operate it. We are hopeful that this initiative will improve safety and patient experience, and reduce the workload for GPs and our provider hospitals.’

A spokesperson for Oxford Health NHS Foundation Trust said: ‘Using Choose and Book patients can leave their GP surgery with a first appointment date, time and location. Or, if they prefer they can choose to arrange their appointment at a later date via the Choose and Book website. GPs benefit by being able to get a much clearer sense of how a referral is progressing. They can track the status of a referral and see what current waiting times a service is experiencing.’