PCTs will have to set up on-line booking as GPs drag their feet

20 Jan 05
Primary care trusts will be forced to set up their own on-line booking services for hospital appointments to overcome GPs' reluctance and meet government targets on Patient Choice, their representative body has told Public Finance .

21 January 2005

Primary care trusts will be forced to set up their own on-line booking services for hospital appointments to overcome GPs' reluctance and meet government targets on Patient Choice, their representative body has told Public Finance.

The NHS Alliance, which speaks for PCTs across the UK, says the government's imposition of the reforms without consulting GPs has backfired, and many will simply refuse to implement them.

Ministers want all patients for non-emergency treatments to be able to choose from four or five different hospitals and book their appointments electronically by December 2005.

But Dr Michael Dixon, the alliance's chair, has told PF that the government will have to be much more flexible about how the reforms, called Choose and Book, are implemented if they are to have any hope of meeting the target.

He warned that ministers will have to abandon the idea of offering the service through every GP surgery. Dixon said a PCT might instead have a telephone line to provide information about different hospitals and process all Choose and Book requests. GPs would give the number to every patient wanting to use the service.

'A lot of GPs feel this has been dumped on them, and are not keen on having to discuss the merits of five different hospital car parks while carrying out consultations with patients,' Dixon said. 'What will happen is that GPs won't do it and PCTs will have to put in place arrangements to offer Choose and Book if the patient actually wants it.'

Dixon's comments follow an announcement by Health Secretary John Reid on January 19 of £95m in 'cash incentives' for PCTs that meet implementation targets. That money was found after a National Audit Office report, published the same day, said only 60% to 70% of the NHS would meet the December 2005 target and further slippage was a 'significant risk'.

By the end of last month, it found, just 63 hospital appointments had been booked electronically against a target of 205,000. The NAO blamed the government's failure to 'engage the support of GPs' and said it must urgently address the problem. A survey of 1,500 GPs by the NAO showed that 60% were hostile to the reforms.

The roll-out of the IT systems is also behind schedule, the NAO found, and there are compatibility problems between systems in hospitals and GPs' surgeries.

Reid, speaking at the New Local Government Network's annual conference, said the cash rewards would help speed up roll-out of the reforms.

He said the money would go to PCTs that install the necessary systems by June; that book 50% of appointments on-line by October; and book 90% of appointments on-line in 2006. They will be able to decide how to spend the cash. Reid said the DoH would make greater efforts to win round sceptical GPs.

'Since last autumn, as planned, my department has intensified its efforts to engage with GPs… This engagement will increase during this important next stage of implementation,' he said.

But Dr Richard Vautrey, the British Medical Association's GP negotiator with responsibility for IT, remained unconvinced.

'Financial incentives will not address the fundamental problems that GPs have with the new system. These include the effect on the quality of the consultation and the extra time required.'

PFjan2005

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