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RCGP rejects Government plans to force GPs to refer patients through Choose and Book



Exclusive: The RCGP has hit back at Government plans to force GPs to refer patients through Choose and Book or call around multiple hospitals to check appointment availability in person, in its response to radical plans to expand patient choice.

The plans, first reported by Pulse in May, could force practices to adopt ‘labour intensive’ methods, such as calling around hospitals to book the appointment themselves,  if they refuse to use the system.

But in its official response to the DH’s consultationLiberating the NHS: No decision about me, without me, the RCGP called for ‘radical improvements’ to the speed and reliability of the electronic booking and referral system, which it said was ‘unpopular’ with GPs as they found it ‘cumbersome’.

The College said the DH’s plans to publish statistics of Choose and Book uptake in order to encourage its use ‘fails to tackle the root cause of low levels of participation in Choose and Book in some places’.

‘Radical improvements to the speed and reliability of the system’ are needed to make it work for both patients and doctors, it added.

It said the proposal to make Choose and Book an information and booking system for patients, through NHS Choices, would threaten GPs’ gatekeeper role and generate ‘extra costs and unnecessary, possibly harmful procedures’.

The College also voiced concerns that information presented in Choose and Book could give a ‘misleading impression’ by obscuring details such as follow-up waiting times, though it admitted that the Government’s proposals to modify the standard contract might help with this.

The response on Choose and Book concluded: ‘As it stands, Choose and Book utilisation will not be the best metric to judge the success of shared decision-making.’

The RCGP also took issue with the DH’s definition of shared decision-making in the proposal, which they said was synonymous with patient choice, including choice of provider.

Offering a free choice of provider could increase costs and health inequalities, make local commissioning of services more difficult and lead to disappointment of patients, they warned.

They added that forcing doctors to ignore their clinical judgment in favour of supporting consumer choice carried the risk that they would emotionally withdraw from their patients’ care.