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Quarter of a million lose out under C&B

A quarter of a million patients referred through Choose and Book have missed hospital appointments they would otherwise have attended, a Pulse investigation reveals.

Hospital 'did not attend' rates, a reduction in which was sold as a key benefit of Choose and Book, have not fallen anywhere near enough to make up for the 10% of patients who fail to book appointments at all under the system.

The Pulse investigation suggests patients referred under Choose and Book are 55% more likely to miss out on hospital appointments than those referred by letter.

Pulse surveyed hospital trusts across England this week and found the system was typically reducing DNA rates by about a third. However, Connecting for Health has already admitted that one in 10 patients referred via Choose and Book fails to ever book their appointment.

Combined, the figures show an estimated 17% of patients referred via Choose and Book do not ever make it to hospital – compared with the 11% DNA rate for traditional referrals.

Among 16 trusts who were able to provide figures, DNA rates for Choose and Book varied widely. Although the Royal Devon and Exeter Foundation Trust said it had cut them by two-thirds, 11 trusts said they had cut DNAs by less than a third, and Weston Area Health Trust even reported a higher DNA rate with Choose and Book.

Dr Mark Davies, medical director for Choose and Book, said Connecting for Health did not collect national figures on DNA rates but he acknowledged the number of patients missing out on appointments could be 'slightly increased'.

He added: 'Some areas have seen very dramatic reductions in DNAs. Inevitably you will find some that aren't getting the benefits we predicted because they're at an earlier stage.'

Dr Margaret Hamilton, a GP in Brentwood, Essex, said: 'These figures inspire me to encourage the partners at our prac-tice not to get involved in it.'Dr Andrew Mimnagh, chair of Sefton LMC, said: 'It goes along with the experience of most GPs that although we feel ultimately electronic booking is the future of the NHS, the current system is too cumbersome and unwieldy to work.'

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