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Independents' Day

New choose and book system 'will be based on flight bookings'

The e-referral system that will take the place of choose and book will be based on the design of flight booking systems and will be easier to use in order to encourage GPs to use the system, NHS England has said.

NHS England today said that the relaunched system - first reported by Pulse last month - will not be compulsory for GPs, but practioners will take up its use as they will see the ‘value’ in it. GPs who do not use the system will continue to have to offer the same choice as that offered by the system, which could include ringing round hospitals.

GP leaders welcomed the easier use but warned that NHS England is in a ‘fudge’ position, as the system itself is secondary to the lack of availability of hospital slots.

The scheme, intended to support the move to a ‘paperless NHS’ by 2018, will be based on the design of flight booking websites and will be integrated with existing clinical systems, NHS England’s director of strategic systems and technology Ms Beverley Bryant told delegates at the Commissioning Show.

Ms Beverley Bryant said the new system will have one ‘back end’ which contains the hospital appointments, and different ‘front ends’ for clinicians, patients and commissioners to actually book the appointments in the same way flight booking websites work.

She said: ‘If you book an airline there will be the back engine with all the BA flights, because you can’t have people double booking seats on the same flight, but you can access it through or or other front ends. That’s the analogy we’re trying to create.’

Ms Bryant said that although she did not want to mandate GPs to use the new e-referrals service, she hoped all GPs would end up using the services because they saw the value in it.

‘We could put it in the standard contract but I want to get to a tipping point where, if 75% of GPs use it, it makes sense for everyone to use it,’ she said. ‘We want GPs to be persuaded to use it, want to use it because they see the value of it.’

GPs who do not wish to use the system will still be obliged to offer the same choices as the system, meaning they would have to manually phone around hospitals for appointment to check availability in person if they opt out of the e-referral system, she confirmed.

The system will ‘facilitate better communication between GPs and their secondary care colleagues’ and will allow patients to be notified of their appointments by email, text or through a mobile phone app, though they can still receive a paper referral if they’d prefer, she added.

NHS England’s clinical informatics advisor Dr Mamood Nazir said that the new system will allow GPs to see the outcomes of all their referrals, helping them to select which the most appropriate service and provider for patients. This would hel commissioners, who can follow a patient’s journey through a pathway, he added.

The system is being developed after consultation with GPs, hospital consultants, commissioners and patients, and a five month consultation begins today where GPs have the opportunity to give their input.

Health secretary Jeremy Hunt welcomed the announcement. He said: ‘E-referrals will be an important improvement on the Choose and Book service, which was sometimes more about the booking and less about the choice. I welcome NHS England’s work to bring in a better system and urge patients and professionals to contribute to the consultation.

Dr Andrew Mimnagh, a GP in Southport and former chair of Sefton LMC, said he was pleased NHs England was committed to fixing some of the problems with Choose and Book.

He said: ‘The general principle of Choose and Book is entirely laudable, it’s the implementation where it has failed. I’m gratified they feel improved user interface is helpful. I hope it tackles the problems in our area. In a little town called Southport, the system says a hospital in Blackpool is eight miles away, but its only accessible in eight miles if you use a helicopter or a hovercraft. It’s a 60 mile round trip. If that hospital is ruled out of it then that would be welcomed.

However, he added: ‘If your local hospital is not offering availability in a service you know is there, no amount of technical wizardry can remedy that. It’s interesting that NHS England is in a fudge position. The last minister was on record saying he wanted to make paper referrals so onerous that GPs would have to use choose and book. Its gratifying to hear they now want to improve the ease of professional access to the system, but notable that the redesign is only taking place because performance management functionality being introduced.’

Readers' comments (2)

  • Excellent. Will this include a fine for people who turn up with the wrong paperwork?

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  • It'll make it easier to integrate with flights to Poland or anywhere else Ranair chooses to send you.

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