1 in 5 referrals now done via C+B

More than a million referrals have now been made through Choose and Book but four out of five referrals have yet to be put through the scheme according to the national clinical director of primary care.

Dr David Colin Thomé wrote to GPs last week to remind practices that the measurement period for the choice and booking incentive scheme would begin on 1 September.

In the letter he told practices: “I’d like to congratulate practices on the hard work that has already been put into implementing Choose and Book: over one in five people referred are now benefiting from the system. However, that means that four out of five are not, so there is still much to be done.”

Latest statistics from the NHS Connecting for Health (CfH) website show that 1,000,966 bookings had been made through Choose and Book by 29 August, a milestone predicted by the Prime Minister earlier in August (link: http://www.ehiprimarycare.com/news/item.cfm?ID=2052 ).

In the letter Dr Colin Thomé underlines to practices that retention of the aspiration payment for the booking element of the directed enhanced service (DES) will depend on making at least 50% of referrals though Choose and Book between 1 September and 28 February 2007.

He adds: “With measurement starting from 1 September, and the maximum payment not available unless you reach 90% utilisation, you will wish to maximise your use of Choose and Book for referrals as soon as possible.”

Dr Colin Thomé urges GPs to contact their primary care trusts (PCTs) if providers are not making slots available through Choose and Book. He says guidance will be published at the beginning of September to enable urgent two week referrals to be made through the system.

The letter also addresses the choice element of the DES, a part of the scheme which means payment to practices will depend on patients’ ability to remember being offered a choice at referral when later questioned for a survey. GP representatives have raised concern that patients may be unlikely to remember being offered choice.

Dr Colin Thomé tells GPs that results from the first wave of the national, PCT level patient choice survey which is being administered via acute trusts show a wide variation in practice across the country.

He adds: “The survey also shows that increasing the publics’ awareness of their entitlement to choose their provider (when referred for their first hospital outpatient appointment) is very likely to have a large impact on their ability to remember being offered a choice.”

Dr Colin Thomé advises practices to take actions to increase the likelihood that patients will recall being offered choice including displaying ‘Choosing your Hospital’ posters in practices, and handing out the ‘Choosing Your Hospital’booklets.

The details of the survey, which will also cover access, are still being discussed between NHS Employers, the British Medical Association’s General Practitioner Committee (GPC) and the Department of Health. Dr Richard Vautrey, a GP in Leeds and GPC negotiator, told EHI Primary Care that he did not know when the survey would be ready but concern about whether patients would remember being offered choice continued to be a key focus.

He added: “It’s one of the things we continue to emphasise. Any survey on choice needs to be done at a stage where the patient could reasonably be expected to remember. It would be no good asking about a discussion that took place a year ago.”