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At the heart of general practice since 1960

A turn-up for the books

A key aim of Choose and Book was to cut the number of patients who missed their hospital appointments. After all, if a patient could have an appointment when and where they wanted, why would they miss it?

A key aim of Choose and Book was to cut the number of patients who missed their hospital appointments. After all, if a patient could have an appointment when and where they wanted, why would they miss it?

That idea always seemed a little neat for this messy real world, given the multiple reasons for not turning up, and a Pulse investigation has now convincingly torpedoed the Connecting for Health case.

DNA rates are down a little – by about a third – but have fallen nothing like as much as Connecting for Health had wanted. When you add in the 10% of patients who under Choose and Book don't even make an appointment, you have a quarter of a million patients so far who would previously have got to see a specialist, but now have not.

Damning evidence

All of this is pretty damning, particularly as it comes just a week after Pulse revealed a series of abuses of Choose and Book by hospital managers. Dr Mark Davies, the system's medical director, has bravely defended it against a barrage of criticism, and persuasively argued for some form of electronic booking. But he was far less convincing when claiming the Choose and Book system was not at all at fault for its use for referral management.

The case is building for a fundamental overhaul of Choose and Book. Some form of electronic booking is here to stay. But the current system has to go.

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