GPs are slowly becoming more knowledgeable about Choose and Book and its implications while gradually becoming more negative about it, according to a survey undertaken by, commissioned by the National Audit Office for Parliament’s Public Accounts Committee.

74% of respondents to the survey said that they knew a lot or something about Choose and Book, compared to 50% last year. However, negativity has also risen from 45% of GPs describing themselves as feeling "very negative" compared to 34% last year, with a similar rise in those feeling "a little negative".

"The pattern which has emerged is that GPs are better informed and more knowledgeable about Choose and Book this year compared to last but are generally less positive about the system," says the report.

The findings represent a mixed bag for Connecting for Health. Although more GPs say they understand the benefits (72% compared with 53% in 2004), they identified fewer benefits than last year and more believe that greater resources would be needed to implement the system for disadvantaged patients.

GPs were also asked about the practical implications of the installation of the sytem. The majority of GPs felt that their working practices would be altered – 88% this year, from 84% last year.

A common perception from GPs was that "implementing Choose and Book will need more administration staff which the GP will have to pay for. Associated with this are the support requirements of a confidential area/room – which many don’t have.

"Generally they feel that Choose and Book will raise questions with patients and that this will take more time for everyone to deal with."

There was no change in the large number of GPs who felt their workload would increase because of Choose and Book – 90% in both 2004 and 2005. However, 10% more GPs now think that they have the resources to implement the system, although the survey states "the majority of GPs still are of the view that their resources are not adequate."

This year, 93% of GPs are of the opinion that the consultation process for Choose and Book has been inadequate, a drop of only 4% from last year.

The NAO commissioned to undertake the survey at the end of September 2005 for presentation to the committee, which is responsible for overseeing government expenditure. The committee is currently investigating patient choice at the point of GP referral for a future report.

Connecting for Health also presented evidence to the committee, arguing that the number of bookings carried out had "accelerated", and that they had worked hard to publicise and demonstrate the system: "Demonstrator versions of Choose and Book have been produced and distributed, raising awareness of the different ways Choose and Book can be used.

"These have been supplemented by documents aimed at dispelling myths about implementing Choice in both primary and secondary care, developed with clinicians at the Early Adopter Sites."

CfH also explained to the committee the hurdles they were trying to meet: "The challenge for suppliers of existing IT systems is integrating their local existing IT systems with the new, secure applications, and this challenge has proved significant for almost all of them. There are over 11 GP systems and 50 hospital systems, many with various versions and configurations locally."

The largest proportion of respondents came from London and the South-east, however the survey detected no significant regional variations in opinion. Out of the 1500 surveyed, only 8% had actually used the Choose and Book software.

The full survey is available for download in PDF format from EHI Primary Care’s document library.