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Choose and Book to be re-launched

NHS England is planning a major relaunch of Choose and Book in a bid to make electronic referrals ‘universally available’ by 2015 - but the relaunch will be built around a publicity drive and there will be ‘no fundamental change’ to the service itself.

The relaunch, details of which are outlined in NHS England’s business plan for 2013/14 to 2015/16, is designed to help achieve achieve health secretary Jeremy Hunt’s ambition for a ‘paperless NHS’ by 2018, which he has claimed will save £4.4bn.

But the move has been criticised by the GPC, which said that any relaunch would be ‘unlikely’ to succeed unless efforts were made to address the obstacles to GPs using the system.

NHS England’s business plan, entitled Putting Patients First, said: ‘The “Paperless NHS” programme includes the re-launch of Choose and Book which aims to make electronic referrals universally and easily available to patients and their health professionals for all secondary care services.’

It added that the deadline for this ambition was 2015, and re-iterated the Government’s commitment to allow patients to view their GP records online by 2015, as well as book appointments and order prescriptions.

The Choose and Book system has come in for frequent criticism from GPs. Last year Pulse reported that the proportion of first outpatient referrals from GPs booked through the system had dipped below 50%, with GPs reporting problems such as hospitals cancelling appointments if they did not receive a referral letter from the practice within three days.

Dr Nigel Speak, chair of the National Clinical Reference Panel - which advises the DH on the design of Choose and Book - and also Choose and Book lead for Birmingham CrossCity CCG, said he hoped the re-launch would embed the use of the system into GPs’ daily practice.

He said: ‘There is a wealth of data within Choose and Book that can be helpful to CCGs in the future, including what’s being referred, by whom, and to which clinic. Combined with the interest that I see in CCGs, I do hope that a re-launch is going to be effective and will embed Choose and Book into standard practice.’

The relaunch was aimed at marketing the benefits of Choose and Book to GPs rather than overhauling the system itself, he added.

He said: ‘There will be no fundamental change to the application as part of the re-launch. Choose and Book has been undervalued and much of its potential is not recognised. The application really does provide a mechanism for effective, modern-day referral management. If only it were more widely accepted.’

‘The DH-quoted performance figures are misleading as they only include first consultant outpatient referrals. When referrals to alternative health professionals and diagnostics are included, I know that usage is increasing steadily.’

However Dr Chaand Nagpaul, lead GPC negotiator on IT issues, said that there were practical issues with Choose and Book that a publicity-based relaunch would not address or fix.

He said: ‘Simply relaunching is unlikely to do anything useful. We need to understand the issues and obstacles and address the reasons why Choose and Book is not more widely used.’

‘There are issues such as the software not working, the system not functioning properly, poor support, the fact that slow connections it can’t be used and that some hospitals don’t have Choose and Book directories. So there are a range of IT issues leading to low usage of Choose and Book. If the Government wants it to be more widely used it has to be fit for purpose. At the moment it’s not.’

Readers' comments (13)

  • Peter Swinyard

    It's clunky and time-wasting. Does not fit with the "business model" of my seeing patient, discussing referral and typing letter while they are sat next to me. Adds too much time to consultation and really requires employment of secretary to do (not reimbursed). We have a local electronic system in Swindon which works and do not want to be forced to use something less good. Only real use is if someone wants a distant referral and we need to find the right service for them. 99%+ of my patients want to be seen at the local DGH. So no choice necessary. May be different in the cities.

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  • Our GP's have used Choose and Book since its inception. Whilst it does add a little time to a consultation the fact that you can book an appointment directly with the hospital of their choice immediately, is priceless. There are times when appointments are not shown but generally it works for us. It may be that we have better choice because there are so few GP's using this system.

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  • Anyone who has to suffer Choose and Book - I managed to get an appointment after three weeks of frustration. I was so cross I said "don't worry - I am taking Eurostar to Lille and will get MRI done there". Immediately Choose and Book offered me "we can give you an appointment at 3.30 this afternoon".

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  • Choose & Book has been a disaster for patients trying to get access it just does not work well and will effect the operation of the new health & social care system.Large bottlenecks will occur with patients being in no man's land and everybody responsible being in denial.

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  • Vinci Ho

    (1) there is wide variation in terms of 'suffering' and 'benefitting ' from Choose and Book
    (2) certain speciality in hospital is much better than others to provide 'real' appointments consistently , hence, another variation
    (3) Time spent on C&B is always there as a constraint for the consultation . Some GPs are faster than the others.Anither variation. But bottom line is the 10 minutes consultation is eroded by this time spent on C&B . That is undeniable .
    (4) Exactly what is this relaunching going to do or fix? Need more transparency.Scratching the surface without really tackling the core problems will just make this 'relaunching' another political sound bite from this government .But then are we surprised ?
    (5) Of course, the hidden agenda otherwise is whether a revision of C&B could assist referral management team more easily to 'scrutinise' all referrals. This is out for further debates.......

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  • David Bush

    I took my car to the garage the other day and said to the mechanic "It gets me from A to B most days, but it's slow and noisy, and it can be unreliable. I want to carry on using it if you can fix it up for me".
    He replied "Oh no, we can't fix it for you. In fact I'm not even prepared to look under the bonnet. But what we can do is repaint it and publicise its relaunch. Will that help?"

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  • Well said Mr Bush,how can choose and book work with so many cancellations and changed appointments ?until a system is found to reduce these C&B will never work as it should.

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  • Another idea full of w*nk!

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  • Hadrian Moss

    We have embraced Choose & Book from the outset but from day one decided never to use it in the consultation.

    After counselling patients over their options the booking process is then delegated to our highly skilled secretary.

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  • Choose and Book is useful. My Gripes are that many services aren't on Choose and Book Mr Hunt and secondly it's 3 days for routine letters and 1 day for urgents-If a patient can luckily get through straight away-then sometimes the department has been on the phone to us saying "where's the letter!!!!!!!!!!!!!" only 1-2 hours after I have seen the patient-and they never exclude weekends (despite rules) in the timescales so start ranting and raving on a Monday morning if the referral was done Friday evening.

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