NHS Connecting for Health has announced that 20m referrals have now been made through Choose and Book.

The Department of Health’s IT agency said the achievement was a "key milestone" for the e-booking system, which was launched in 2004.

However, the figures also show that the system is currently used for around 50% of first outpatient appointments; well short of the 90% target originally set by the DH.

CfH said more than 30,000 referrals are made via Choose and Book every day and Dr Stephen Miller, national medical director for the Choose and Book Programme, said patients appreciated its greater flexibility.

He added: “Reaching 20m patient referrals booked through Choose and Book is a significant milestone for the NHS and has given those patients that have used the system much more certainty and control of their health care at a very uncertain time in their lives.”

CfH said that Choose and Book “when used as intended” provided significant benefits for referrers, providers and the wider NHS. Late last year CfH issued guidance on the “correct use” of Choose and Book because of wide variation in the way the system is used.

Concerns included slot availability or hospitals failing to put appointments on to the system, in some cases because of attempts to meet other DH directives such as the 18 week referral to treatment time target.

This week Dr Miller said: “We continue to work with provider organisations (in both primary and secondary care) to encourage them to place all of their services and appointments on Choose and Book, thus ensuring that referrers will always turn to Choose and Book as their standard method of referral.”