Parts of NHS Direct, the Choose and Book service and the current ‘consent to view’ model of the Summary Care Record should all be reviewed to save money in the financial crisis, the BMA’s GP leader, Dr Laurence Buckman, said today.

With NHS trusts under pressure to achieve efficiency savings of up to £20 billion by 2014, Dr Buckman, who chairs the BMA’s GP Committee, said: “Government must be determined to avoid wasteful and ‘un-evidenced’ policies.”

Dr Buckman suggested that no mercy should be shown to other areas of NHS policy, including "wasteful" PFI projects, the GP Survey, management consultants and ‘"the bureaucracy of the NHS market".

These should be “consigned to the dustbin of history,” he told the annual meeting of BMA Local Medical Committees in London today.

Dr Buckman acknowledged that while there had been record investment in the NHS in recent years, there were “worrying” times ahead “because government needs to ensure that the pursuit of major savings and efficiencies does not adversely affect patient care.”

Parts of NHS Direct: Dr Buckman said that NHS Direct still refers many of its patients on to GPs or accident and emergency departments and there is little evidence that it relieves pressure on GP or hospital services.

While the NHS Direct website is a valuable resource and should be retained, the cost-effectiveness of other parts of NHS Direct should be reviewed, he argued.

Choose and Book: The GP leader said many practices find the e-booking element of Choose and Book useful. However, he said the ‘choose’ element is laboriously bureaucratic and requires a lot of expensive NHS staff time and management.

The system is now regularly used to ration demand and meet the 18 week waiting times target by PCTs, he argued. In practical terms it is often difficult for patients to exercise real choice.

The current ‘consent to view’ model of the Summary Care Record: The BMA agreed to the current consent model for the duration of the SCR pilots, on the basis that there would be a thorough independent evaluation before it was rolled out further.

This is due to be published soon, and Dr Buckman argued that the premature roll-out of this scheme is costly and inappropriate.

He also suggested a review of building new walk-in centres and Darzi Clinics. He said existing centres needed to be properly integrated with local services and that new centres should only be opened after adequate consultation and an assessment of local need.