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10% of patients fail to book clinic under Choose and Book

By Steve Nowottny

Patients are more likely to miss out on outpatient appointments if they are left to book themselves in under Choose and Book than under the conventional referral system, Pulse can reveal.

Figures from Connecting for Health show that one patient in 10 fails to book themselves an outpatient appointment using the system. This comes on top of patients who do book appointments but fail to attend.

The vast majority (91%) of patients in England book their appointments themselves under Choose and Book – a figure many GPs welcome. But the new figures appear to back claims from some GPs that patients who are left to book their own appointments through the controversial electronic referral system are at increased risk of slipping through the NHS net.

Dr Mark Davies, Choose and Book medical director for Connecting for Health, said the 10% drop-out figure, the equivalent of almost 400,000 patients, was equivalent to the national did not attend rate.

But he admitted that as some patients who successfully booked appointments through Choose and Book subsequently failed to turn up, the overall number of patients missing appointments was likely to have increased under the system.

'I wouldn't feel confident enough to say there is no increased rate,' he said. 'But what we're seeing is that the DNA rate among Choose and Book referrals is very significantly reduced and certainly isn't 10%.'

He said that although no national figure existed, typical DNA rates reported so far may be about 3%. If these figures were applied nationally, more than 100,000 extra patients would have missed appointments under Choose and Book.

Dr Davies said that patients who failed to book their appointments would receive a reminder after seven working days, and a second reminder after a further seven working days.

'It's not true to say that these patients are being lost in the system – they are more visible than they were in the old system,' he insisted.

But Dr Ruban Prasad, chair of South Lancashire LMC, said that the elderly, infirm, people suffering with mental health problems or those whose first language was not English could have particular problems.

'I think a small number of patients will slip through the net, but even if it is one, that's too many,' he said.

Dr Angelique Mastihi, medicolegal adviser for the Medical Protection Society, warned that any 'lost' patients could have serious consequences for GPs, who could face legal action from patients 'who may try and say "if the doctor had adequately informed me, I would have booked"'.

Choose and Book was also criticised in the House of Commons last week. Upminster MP Angela Watkinson described how a constituent with a family history of cancer had spent nine weeks struggling to book an urgent outpatient appointment.

Dr Davies said hospital booking lines were getting more reliable.

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