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Government slams hospitals for manipulating Choose and Book to hit 18-week target

By Steve Nowottny

The Department of Health has issued a stern reprimand to hospital trusts for manipulating the Choose and Book system in order to help meet the Government's flagship 18-week target.

Nick Chapman, who heads up the 18-week programme and is the DH's senior responsible officer for Choose and Book, has written to SHA chief executives warning ‘significant numbers' of hospitals are restricting appointment slot availability.

Pulse first revealed in February that 90% of hospital trusts have cut their Choose and Book polling ranges – the number of weeks GPs can book appointments in advance – in order to help meet the Government's target of a maximum 18-week wait between GP referral and hospital treatment.

Mr Chapman told SHA bosses: ‘It is of concern that, contrary to the principles set out in the Operating Framework, there are significant numbers of providers restricting the publication of outpatient appointment slots on the system and preventing patients from booking appointments directly.

‘As a result, some patients are being inconvenienced and confused by a system that is supposed to enable them to book an appointment, but in practice does not. The experience for patients is not what it should be.'

Dr Andrew Mimnagh, chair of Sefton LMC, said that while overall Choose and Book was getting ‘a little better', hospital trusts in his area frequently restricted appointment availability for certain specialities.

Orthopaedics appointments had been ‘unobtainable for the vast majority of the last nine months,' he said. ‘It's like the Yeti. I hear reports from colleagues that occasionally they've found appointment slots that were not there by the end of the day.'

Hospital managers were under impossible pressure to deliver conflicting Government priorities, he added.

‘One side is saying choice is important, the other is saying you've got to hit the 18 week target,' he said. ‘They're two contradictory policies.'

Choose and Book recently celebrated its ten millionth booking, and is now being used in 91 percent of GP practices and all NHS acute trusts.

Choose and Book medical director Dr Stephen Miller welcomed the milestone, claiming: ‘It gives a clear indication that Choose and Book is making good progress in becoming the NHS's everyday method of referral.

But the percentage of outpatient referrals made through the system remains stuck at 50% - a milestone first reached in February.

Dr Andrew Mimnagh: GPs will find Choose and Book a burden if incentives are scrapped Dr Andrew Mimnagh: GPs will find Choose and Book a burden if incentives are scrapped Letter from Nick Chapman, National Director 18 weeks, senior responsible officer Choose and Book, to SHA Chief Executives, 21 August

'It is of concern that, contrary to the principles set out in the Operating Framework, there are significant numbers of providers restricting the publication of outpatient appointment slots on the system and preventing patients from booking appointments directly.'

‘As a result, some patients are being inconvenienced and confused by a system that is supposed to enable them to book an appointment, but in practice does not.'

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