In an e-mail exchange leaked to the Sunday Times the NHS IT director general Richard Granger is said to have told Margaret Edwards, director of access and patient choice at the Department of Health, that Choose and Book’s GBP20m IT build contract is now in grave danger of derailing (not just destabilising) a GBP6.2 billion program.

Granger went on to suggest that Edwards’ repeated late requests for modifications to the project have proved the greatest obstacle to the accomplishment of the project’s aims.

According to the e-mail exchange, the Choose and Book system is currently falling far short of the original aspirations for an Electronic booking system whereby patients can choose where they want to be treated once they have been referred to a specialist. At present, 32 foundation Trust hospitals are missing from the system in addition to a further 10 private healthcare institutions.

The comparatively limited patient choice is thought responsible for the under attainment of the targeted quarter of a million patients who were expected to have used the service. The figure for users of the service currently stands at a meager 20,000..

Although Granger would be happy to lay all the blame with policy makers such as Margaret Edwards, there is evidence to suggest that the project has been further impeded by software design failures in the earlier trials and a reluctance on the part of GPs to use the service.

These revelations are not a major departure from the history of failed improvement measures the NHS has faced. However, it is becoming increasingly apparent that technology is as susceptible to as many difficulties as past reform measures in its attempts to improve the proficiency of the UK’s national health service.