Dr Paul Cundy is reported as suggesting that a mere 25–30 per cent utilisation of Choose and Book would be a reasonable expectation by April 2007 (GP, 15 September).  

He will be surprised to learn that GPs are about to exceed his expectations. Last week, 25 per cent of patients referred to consultant outpatient appointments were referred through Choose and Book.   

Actual usage of Choose and Book is even higher than this because referrals to specialist primary care services are not included in this figure.  

Clearly the 90 per cent target for PCTs is ambitious, but we should be congratulating GPs for the progress they have made to date. No one ever claimed that implementation of Choose and Book would be easy, because it sets out radically to improve the experience of the 9.5 million patients a year referred to specialist care. I firmly believe that it is worth working through the challenges to obtain the improvements that IT can bring to our traditional referral systems.   

Dr Cundy mentions that his own computer has crashed since the integrated version of his GP system has been installed. Frustrating as this must be for him, many GPs with the same system are using an integrated version successfully. I assume he will be taking his recent problem up with his system supplier.  

He also says he has heard of ‘bookings disappearing after they have been made’. This is a serious accusation and NHS Connecting for Health is committed to investigating all such claims relentlessly under our clinical safety procedures.  There is no evidence that this is occurring, which cannot be claimed of the paper-based system.  

Despite a slow start, the role of Choose and Book in the NHS is now well established.  There are significant implementation challenges ahead but if we keep focussed on the benefits for our patients we will end up with the universal electronic referral system that the NHS deserves.  

Dr Mark Davies  

GP and primary care medical director, national Choose and Book team, NHS Connecting for Health