A key element of the national health service care records service is to provide a transaction messaging capability to support the messaging requirements of all the systems supported by the spine. The cost of spine services relating to choose and book messaging is not separately identified within the contract cost of the care record spine.
(2) what budget has been set to fund the necessary revisions to the general medical service contract in respect of the (a) choice and (b) choose and book component;
(3) what estimate she has made of the cost in each of the next five years of providing financial incentives to GPs to use the choose and book system if all GPs were to register and employ the choice and choose and book component.
The payments available to primary medical care contractors for utilisation of the choose and book service and for delivering choice to patients were agreed as part of the amended contractual arrangements that run from April 2006 to March 2007. Whether there is a need for payments in future years will be a matter for consideration by NHS employers in the context of their continuing review of the contractual arrangements as a whole.
The full value of the directed enhanced service (DBS) is 96 pence per registered patient. There are approximately 53.3 million registered patients in England. Assuming that every practice in England meets the full requirements of both components of the DES, the value of the DES in 2006-07 could be just over £50 million, which is funded as a relatively small part of the growth in overall resource allocations to primary care trusts.
No estimate has been made of the administrative cost of each referral made using the choose and book service. However, the choose and book service should reduce considerably the overall administrative burden of managing referrals.
This is a matter for individual primary care trusts and strategic health authorities.
I refer the hon. Member to the second paragraph of the reply given on 16 May 2006, Official Report, column 935W:
The full value of the directed enhanced service is 96p per registered patient and comprises two equal components, one for choice (48p) and one for choose and book (48p). Half of the choice component, worth 24p will be made as an aspiration payment to those general practitioner practices who make a written commitment to ensure that choice is offered to relevant patients. The remaining half, also worth 24p, will be paid based on the results of a new survey of patient experience.
(2) on the choose and book system, what assessment she made of likely take-up of the choose and book system without the financial incentives available to GPs who register and use the system; and what definition of relevant patients her Department uses when assessing applications for aspiration payments.
The Department strongly believes that both choice and choose and book deliver significant benefits to patients, and both primary and secondary care practitioners. The choice and booking direct enhanced service (DES) is designed to encourage general practitioner (GP) practices to proactively implement choice and the choose and book service in order to realise these benefits early, as opposed to GP practices adopting at their own pace. However, no specific assessment has been undertaken to determine what uptake would have been if financial incentives had not been made available.
In the choice component of the DES, relevant patients for aspiration payments are those referred from primary care to secondary care, where a specialist’s opinion is needed and the current nationally agreed guidance on choice exclusions do not apply.