A London PCT is to pay its GPs £3.50 for every referral made under Choose and Book as trusts step up their efforts to improve take–up of Choose and Book.

Bromley PCT has set up a local enhanced service which will pay GPs £3.50 for each referral made using the e-booking scheme. However the local medical committee has warned that take-up will only improve if slot availability also improves at local hospitals.

In August Nick Chapman, national director of Choose and Book, wrote to all strategic health authority (SHA) chief executives telling them to sort out problems with slot availability.

London is the worst performing strategic health authority on Choose and Book followed by East of England SHA.

In its September board papers East of England SHA says its PCTs booked 44% of referrals through the Choose and Book system against an England average of 53% for the week to 31 August. Worst performers were East and North Hertfordshire and Suffolk PCTs which booked 33% and 34% of appointments using Choose and Book in the week to the end of August.

As a result East of England SHA is setting up an Intensive Support Team with technical, primary care and acute sector expertise to review each underperforming PCT and come up with an action plan to improve take-up.

South East Coast SHA is another less successful authority with 45% of referrals going through Choose and Book in August. The SHA has asked all PCTs to complete a comprehensive recovery plan to improve performance to 75% by December and achieve the 90% target early in 2009.

The SHA said slot availability also varied widely. Frimley Park NHS Trust had slot availability of 28% at the end of August compared to 5% at hospitals such as Ashford and St Peters and Royal Surrey County Hospitals NHS Trust,

The SHA has told PCTs to get an action plan and trajectories from their providers which result in no more than 5% of slots being reported as unavailable on a weekly basis.