While 36 per cent plan to offer choice eventually, 24 per cent said they had no intention to do so.
This will be a blow to the DoH, which has already missed one Choose and Book target. The NHS Plan set December 2005 as the target for all patients to be able to book a convenient appointment at the point of GP referral. In August 2004, this target was refined and patients promised a choice of four or five hospitals.
There is now a new deadline of 31 March 2007 for 90 per cent of GP referrals to be made through Choose and Book and the DoH has told PCTs to prepare month by month plans to plot progress towards this.
However, GPs are not contractually obliged to offer Choose and Book, so the DoH and PCTs have been forced to find other ways of engaging them in the choice agenda.
From April, GPs pledging to offer choice through Choose and Book will be rewarded through a new directed enhanced service (DES). But only 36 per cent of respondents said that this DES had made Choose and Book more attractive.
The DoH has also tied practice-based commissioning to Choose and Book, hoping that its potential rewards will make Choose and Book more palatable to GPs.
PCTs have also been offered financial incentives by the DoH for persuading practices to sign up to Choose and Book, and more than half of GPs said they had been pressurised by their PCT to do so.
For most, this has been gentle persuasion consisting of meetings and correspondence outlining the initiative's advantages. Some PCTs have also offered practices financial rewards or new computer equipment and a minority have told GPs falsely that it is a contractual obligation.
Six out of 10 GPs now have the Choose and Book software, but only 25 per cent of those currently offering Choose and Book make the booking themselves.
Professor Mike Pringle, joint GP clinical lead for Connecting for Health, was not put off by the low uptake. 'Overall the results are much as expected,' he said.
GPC negotiator Dr Richard Vautrey said he would expect more practices to sign up with Choose and Book once technical problems were ironed out.