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CAMHS won't see you now

Choose and Book blameless

From Dr Mark DaviesPrimary care medical director, Choose and Book

I am surprised by the story 'Exposed: referrals system in disarray' (News, 30 November). It is simply not true to say that patients cannot be prioritised between urgent and routine referrals. Every referral in Choose and Book has a priority allocated to it by the GP according to their clinical judgment.

The system reveals those appointments allocated for those priorities; this means that getting an appointment linked to a priority is easier in Choose and Book when compared to a paper-based system. If on reading the referral letter the consultant disagrees with the priority, the consultant has the ability to change the priority and mark the appointment for rebooking.

Clearly, all patients should be treated according to clinical priority regardless of whether they are paper referrals or Choose and Book referrals, and hospitals should have local policies and procedures in place to ensure there is fairness in hospital waits. But, as with any project of this size and complexity, the NHS needs to adapt to changes being made.

We are at a stage when many hospitals are currently trying to run both Choose and Book and paper-based referral systems at the same time and this is challenging. Some hospitals are now requesting that their local GPs only use Choose and Book as it is seen as a safer, more efficient system, offering better patient experience.

It is odd to see Choose and Book blamed for the games that some hospitals are said to be playing in attempting to meet 13-week targets. The Department of Health has made it clear that it expects patients to be able to choose to go to a particular hospital, even if the hospital cannot provide an appointment within 13 weeks.

A patient who is not seen at the hospital of their choice within 13 weeks is counted as a breach regardless of any capacity issues. Of course patients also have the choice to wait longer should that be what they want.

These are not Choose and Book issues. Hospital services should not be being excluded from lists simply because they are struggling to meet the 13-week targets.

This achieves nothing, as the patient does not go away and they still need to be referred.

Certainly, Choose and Book does not limit access to any service on the basis of waiting times. And I'm sure the Department of Health would be keen to hear from any GPs who are seeing this happening in their area.

From a technical perspective, Choose and Book is able to publish available appointments 180 days in advance, but the actual way this is used by a hospital is up to them. To blame Choose and Book for this is a bit like blaming town planning on the map makers!

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