NAO delivers report on NHS choice target

The National Audit Office (NAO) has reported "significant risks" in struggling plans to meet targets to deliver a choice of four or five hosptials to NHS patients by the end of 2005.

The NAO's report, 'Patient Choice at the Point of GP Referral', has found that, although progress has been made in the plan to offer each patient referred by a GP for non-emergency hosptial treatment a choice of four or five healthcare providers, there are still problems in meeting the target of December 2005.

The report states that many GPs have not been successfully engaged by the plan. An NAO survey of GPs found that around half knew very little about the policy, while around 60% felt "negative"about the plans, expressing concerns that their practice lacked the capacity to deliver choice and that their workload, and length of time for consultations would increase.

The new system aims to allow patients to choose their preferred location for treatment, from a menu of NHS and independent healthcare providers, in consultation with ther GPs. The choices are to be delivered through the 'Choose and Book' system, but it will not be universally available until December 2005.

The government is planning to mount a campaign to inform and engage GPs, whose support is vital to make the new plans work, in 'Choose and Book' this year.

Sir John Bourn, head of the NAO, said that some progress had been made towards delivering choice at referral, mainly through the establishment of the necessary infrastructure, such as new IT systems. However, the NAO admitted that parts of the NHS "still have much to do", if they are to be able to deliver choice. The report revealed that a "significant minority" of primary care trusts do not have adequate plans in place to offer patient choice and "may struggle" to manage the required new commissioning arrangements. Over a quarter of these trusts have forecast that they will not achieve the choice targets and two thirds have yet to commission the required number of providers.

Sir John said that the Department of Health must take "urgent and effective action" to inform and engage GPs on the new arrangements.

Health Minister, John Hutton, said that efforts to engage GPS have "intensified".

He said: "More than 2,500 GPs have already been involved in developing systems to support choice and booking and this engagement will increase during this important stage of implementation."

However, Dr Hamish Meldrum, Chairman of the BMA's General Practitioners Committee, said: "GPs feel that they are working in an information desert and will need much more detail and experience of what is involved before they can be convinced of the benefits. Many GPS are still not completely satisfied that the system will protect confidentiality and will not have confidence in the new system until this is properly addressed."

(KMcA/SP)