What seems to be the problem?
GPs and clinicians are still having problems with the online hospital appointment booking and referral service, Choose and Book.
The Choose and Book system is designed to allow NHS patients in England to choose a hospital, date and time for their outpatient appointments and more than 13 million referrals have been made using the service to date.
According to research by the British Medical Association (BMA), GPs reported the Choose and Book still has issues with reliability and slowness.
"Trusts and PCTs [Primary Care Trusts] cannot expect clinicians to be enthusiastic about a system if it is unreliable or slow and must ensure that local systems are fit for purpose and properly maintained if widespread use is expected," the report said.
"System reliability is reported as a significant barrier to use of the system... Whilst GPs acknowledged that system reliability has improved, they still experienced problems with speed and systems crashing," it said.
One practice said it took up to 30 minutes to reboot their systems when Choose and Book crashed, while another said the system crashed for 50 per cent of referrals.
Consultants using Choose and Book to review appointments also said they were struggling with its slowness.
According to the report, GPs say that reliability has improved, however, and issues vary between practices.
"The GP view, on the whole, was that when Choose and Book works it improves the referral process but when it goes wrong it is extremely frustrating to the extent that some find it not worth using," the report said.
The BMA spoke to a number of GPs, consultants and administrators from across the Hammersmith and Fulham Primary Care Trust.
Despite ongoing issues, there were also positive comments about Choose and Book with some interviewees saying they'd be unwilling to go back to the previous referral system.
"Some doctors are very positive and would be unhappy to revert to paper-based referrals," the report added.
Administrators also cited the ability to track the progress of referrals as particularly useful, while the ability to give patients more control and less uncertainty around their appointments was also praised by some medical staff.
Choose and Book medical director, Dr Stephen Miller, said in a statement: "Local problems are more often down to local IT configuration rather than the system itself. This is a supportive report that will help us achieve our objective of making Choose and Book the modern and everyday method of referral across the NHS."
In order to improve the situation, the BMA recommends greater collaboration between primary and secondary care, more appropriate support for users and putting central contacts in place to offer help when problems occur.