An NHS acute trust has been using staff to manually upload paper referrals to boost its Choose and Book performance against government targets.

A report to the board of NHS Cornwall and Isles of Scilly says: “Royal Cornwall Hospitals NHS Trust has been uploading paper referrals to the Choose and Book system to improve performance.”

The report says that in January the percentage of outpatients booked via the electronic booking system was 83%. However, in February performance had dropped to 75%.

The Department of Health requires 90% of GP referrals for first outpatient appointments to be made through Choose and Book.

The primary care trust began working with the acute trust to review booking procedures. The manual upload has helped the acute trust to close in on the national target by boosting performance to 84% by the beginning of March.

In a statement, PCT said: “NHS Cornwall and Isles of Scilly and the Royal Cornwall Hospitals NHS Trust have established a process to ensure that any patients referred on paper are not disadvantaged. This was agreed with the Local Medical Committee and communicated to all GPs.

“The overwhelming majority of referrals from GPs to local hospitals are made via the Choose and Book system and uploaded paper referrals account for only 4% of our overall total.”

Peter Knibbs, chair of NHS Cornwall and Isles of Scilly’s professional executive committee said: “There was a small number of paper referrals going through directly to Royal Cornwall Hospitals Trust and we wanted, through their booking team, to make sure they got uploaded to the Choose and Book system as soon as possible.”

The key idea behind Choose and Book and its targets is for GPs to use it within their surgeries to increase patient choice. Manually uploading the referrals after they have been made does not ensure that this has happened.

Dr Steven Miller, Choose and Book medical director, told the GP magazine Pulse that: “The performance would be improved if GPs all used the same system and sent them through the proper way rather than using a workaround.

“It doesn’t seem right that people in an acute trust are supposed to be acting on behalf of a GP. If that was happening I wouldn’t want to be a GP in that area.”