Surgery where immediate treatment is required is not in the remit of Choose and Book since such patients' needs bypass any longer-term queuing systems.
For a number of reasons some GP and hospital PAS systems had not been made compliant in time to deliver the initial Choose and Book targets set by the Department of Health.
There were conflicting views about its effectiveness, both from a technical viewpoint (it is hard to distinguish between bugs in CaB and the systems with which it interfaces) and a service perspective (some users argue that it undermines existing good practice, while others praise the convenience and reduced delays it offers to patients).
A 2006 survey (published 2008)[2] found that the majority of patients were not experiencing the degree of choice that the system was designed to deliver.
To increase the uptake of Choose and Book by doctors in England, surgeries were offered a financial incentive for the first part of 2006, but it continued to suffer from adverse publicity in the medical press and resistance from a number of GPs.
This meant that a GP could, via CaB, offer their patients the choice of four or more local providers, and the option of any Foundation Trust or accredited independent sector hospital in England.