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.’