Concern over Choose and Book should not prevent GPs from getting involved with practice based commissioning, the British Medical Association’s General Practitioner Committee (GPC) has said.

The GPC has issued new guidance on practice based commissioning (PBC) in which it says that despite some recently introduced disincentives, including Choose and Book, it believes there are some compelling reasons why GPs should take on the commissioning role.

The guidance states: “We do not believe that the fact of having to express an intention to implement Choose and Book should necessarily constrain practices from getting involved in PBC. Practices can always reconsider their position when the final Choose and Book guidance is available and decide whether to continue operating PBC.”

This latest advice from the GPC follows the release of more details on the commissioning scheme from the Department of Health last month. That technical guidance from the DoH stated that practices which want to take part in practice based commissioning will ‘need to demonstrate that they intend to implement Choose and Book in accordance with the national guidance.’

However Dr Peter Holden, a GP in Matlock, Derbyshire and one of the GPC negotiators, said that the guidance only required GPs to ‘demonstrate an intention’ to use Choose and Book.

He told EHI Primary Care: "Half the nation is demonstrating an intention to lose weight or give up smoking but what does that really mean?

"I might demonstrate an intention to implement Choose and Book but I will only use it when I am satisfied it will not impact on my consultation length, on the smooth running of my surgeries or on my staff’s workload and when I am confident that the patient confidentiality issues have been addressed and that Choose and Book will permit patients to be given the appropriate degree of priority."

Dr Holden said GPs had been put off practice-based commissioning which had "some good pluses" in it by the link to Choose and Book and community matrons.

He added: "It could have been construed that unless you were signed up to both those concepts you could not go ahead but our interpretation is that that is not necessarily true."

The GPC’s guidance emphasises that the committee’s ‘serious concerns’ over the booking element of Choose and Book remain. It says the GPC is working with the Department of Health and the National programme for IT to resolve these issues. The GPC also says its original guidance on Choose and Book still stands. That advice outlines confidentiality and workload concerns and suggests that practices’ "carefully consider the implications of being involved in Choose and Book."


GPC Practice Based Commissioning Guidance – March 2005 [DOC, 98K]
DoH technical guidance on practice based commissioning – February 2005 [PDF, 261K]
GPC Choose and Book guidance – November 2004