There are more than 100 referral management centres in England, and the clinical leads say they are intercepting referrals made through the Choose and Book system in some areas.
Connecting for Health clinical lead Dr Simon Eccles said: 'The original vision is that patients either walk out with a booked appointment or a password and phone number to make one. It seems counter-productive to have an extra step in the process that takes away that immediacy.'
GP clinical lead Dr Gillian Braunold said: 'If I make a referral to an orthopaedic team, the booking goes to the referral management service instead of the hospital. This raises the question: what is the patient choosing?'
Interception of referrals via Choose and Book will not affect payments to practices under the choice and booking directed enhanced service (DES).
Dr Braunold said that an electronic referral to a referral management centre counted towards the DES target.