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MPs 'sceptical' about success of new-look e-Referrals system

An influential parliamentary committee has said it is ‘sceptical’ whether NHS England’s new e-Referrals system will be any more successful than Choose and Book, which it will replace from November.

In a report, published on Wednesday, the Commons Public Accounts Committee said Choose and Book was a ‘missed opportunity’, and said NHS England must ‘develop clear plans for how it intends to build up confidence in and utilisation of the new system’ if it was to avoid the underuse of its predecessor.

The PAC report stated that Choose and Book is used for just 50% of referrals at present, and this is costing the NHS £51m in potential annual savings and undermining data quality.

The criticisms of Choose and Book is a blow to the Government, as e-referrals systems are key to the Government’s target of achieving a paperless NHS by 2018.

The PAC’s report said: ‘The Choose and Book appointment booking system […] has been a missed opportunity to improve patient care and data quality. It cost £356m to March 2012, but has had a chequered history and is underutilised, which means that annual savings of up to £51m are being missed.’

It added: ‘Given the difficulty NHS England has had in getting GPs and others to use Choose and Book, we are sceptical about its ability to achieve full utilisation of e-Referrals.’

Choose and Book has been a source of GP frustration with outpatient slots not being properly uploaded, and in some cases being cancelled or delayed by managers, leaving GPs to deal with patient anger.

In summer last year, NHS England announced the scheme would be remodelled based on flight booking systems, but critics have said this won’t solve the problem of hospitals failing to upload appointments.

The committee gave its recommendations after interviewing former NHS England CEO Sir David Nicholson in February.

Sir David told the PAC that ‘[GPs] just don’t like the way the system works and it affects their patients they think they don’t want different ways, and we’ve been unable to persuade them of that.’

He added that NHS England were considering penalising GPs for not using the new e-referrals system if GPs still opted not to use it in future.

Readers' comments (5)

  • "we’ve been unable to persuade them of that.’"

    How about making it so good that we want to use it? Or hadn't that occurred to anybody..?

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  • NHSE + HMG seem to have the reverse midas touch really,everything they touch in th health service seems to go brown+ smelly!

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  • C&B can only be said to "save" these theoretical amounts by dumping additional work on GPs so that appointment management becomes an unfunded primary care task rather than a funded secondary care one. NHSE will be adding insult to injury if not only are we expected to take on the additional work in our own unpaid time but we are being threatened with penalties if we refuse, effectively charging us for referring patients. Can NHSE even attempt to justify that one?

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  • When C&B was first introduced, thwasn't there a DES or LES to encourage uptake by GPs?
    Maybe NHS England should think "carrots" rather than "sticks"?
    In addition, I suspect uptake is geographically patchy: if they looked at the secondary care end in areas of high GP uptake, the answer for non-adoption elsewhere might be obvius: if a system is useful, it tends to get used: and if it isn't, it doesn't.
    Think back: no problems with registration, IOS and path links...

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  • If MP's are sceptical about the new e-referrals system then suddenly I am filled with excitement and anticipation that we may actually get some IT that is fit for purpose. After all, previous incarnations have been hailed as miraculous by the DH, but have been pretty unimpressive. If they were trumpeting this as another great breakthrough, then I would be despondent!

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