The use of the Choose and Book IT system is 'not mandatory', despite increasing pressure on GPs to use it, claims the team rolling out the electronic referrals system.

A spokesman for the National Choose and Book team in Eng-land confirmedthat it was aware that some PCTs and hospitals were only accepting electronic referrals.

The directed enhanced service (DES) for choice and booking ends in March 2008 and the funding is intended to be switched for extended hours from April 2008.

The policy at Milton Keynes Hospital in Buckinghamshire, for example, is to use the Choose and Book system for all referrals, except for those involving a number of urgent conditions such as a cancer.

Spokesmen at neighbouring Bedford Hospital said that in the long term the hospital plans to accept only Choose and Book referrals, 'in line with national guidance'.

However, a spokesman for the Choose and Book team said: 'The service is not mandatory. A provider may only refuse to accept a referral on clinical grounds, or in accordance with the agreement of their commissioner.'

Dr Julius Parker, chief executive of Surrey and Sussex LMCs, said that Brighton General Hospital considered scrapping paper referrals because it did not want to run a dual system. This was because of PCT targets to increase uptake of Choose and Book referrals.

Deputy chairman of the GPC Dr Richard Vautrey said that some hospitals' insistence on Choose and Book referrals was causing consternation.

'One or two trusts have said they are no longer taking paper referrals,' he said.

'Some hospitals want to cut down on their administration costs, so they're pushing those costs out to the community.'

GPs said that a blanket decision on referring patients was not appropriate, given there were circumstances in which a paper referral was preferable.

jonn.elledge@haymarket.com 

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