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By Andy McCue, 19 January 2005 13:05

NEWS The NHS' flagship £64.5m electronic booking system has come under fire from the National Audit Office (NAO), which claims the rollout is behind the original schedule and that there has been a failure to engage GPs in the process.

Under the £6bn National Programme for IT (NPfIT) in the NHS the Department of Health awarded the e-booking contract to Atos Origin in October 2003 with the aim of 100 per cent e-booking by the end of 2005.

But an NAO report out today said roll-out of the system has been slower than planned and that at the end of December just 63 bookings against a projected target of over 205,000 had been made through the system.

The original 'big bang' implantation target of 100 per cent e-booking by the end of 2005 has already been ditched in favour of staged "key milestones", although some of these have now also slipped.

Problems highlighted included the reluctance of users to work with an unreliable system, limited progress in linking to GP and hospital systems, and the limited number of GPs willing to use the system.

An NAO survey of 1,500 GPs in October last year found almost half (49 per cent) new "very little" about the 'Choose and Book' system. The GPs also expressed discontent at the way in which the DoH communicated with them, with 92 per cent saying they had not had the opportunity to feed into the consultation process and 97 per cent saying the DoH had not communicated the timetable adequately.

GPs are also concerned that the e-booking system will affect the way they work with 90 per cent saying they believe their overall workload will increase as a result.

The DoH claims it has always planned for a "back-loaded" communications strategy to fully engage and inform GPs towards the latter stages of preparations for the system when it is fully operational and can be demonstrated properly to the future user community.

Another risk highlighted by the NAO is the lack of an agreed roll-out schedule with the dominant supplier of GP systems, EMIS, which failed to win any of the NHS IT contracts. A target of February 2005 has now been set for this.

Sir John Bourn, head of the NAO, said in the report: "The Department of Health must take urgent and effective action to inform and engage with GPs about the new arrangements. GPs' support may be hard to secure and indeed choice will be hard to deliver successfully by the end of 2005 if the electronic booking system is not largely up and running by then."

Health minister John Reid said the government has intensified efforts to engage GPs since the autumn and today he announced a two-year £95m incentive package to encourage take-up of e-booking by Primary Care Trusts.

In a statement Atos Origin said the NPfIT recognises the delay is not the fault of Atos Origin and that even though the supplier has agreed to defer some payments it will not impact the financial position of the company.