Five million patients benefit from Choose and Book - déjà vu?

NHS Connecting for Health, which runs part of the National Programme for IT, NPfIT, has issued a statement on the Choose and Book system that bears similarities to a government announcement five years ago, in 2002.

Both statements – on 6 October 2007 and 20 May 2002 – said that more than five million patients have been able to pre-book hospital appointments.

The statement yesterday [6 October 2007], was that of the achievement of a “significant milestone” – five million referrals sent through Choose and Book.

The Choose and Book scheme is a good idea: instead of patients waiting for a letter from the hospital giving the time and date of an appointment, it can be pre-booked at a time and date to suit the patient.

Connecting for Health says:

“Patients are now booking appointments electronically at a place, date and time that is convenient to them and they no longer have to put their life on hold while they wait to hear back from a hospital for when their appointment will be.”

Five years ago, on 20 May 2002, the then Health Minister John Hutton told Parliament:

“All acute hospital trusts now have booking systems in place in at least two specialities/high volume procedures and more than five million patients have now benefited from booked appointments.”

And the Department of Health said in its Departmental Report 2003:

“The National Booking Programme was launched in 1998 as part of the Government’s strategy for Modernising the NHS. Booking is the key means of delivering ‘choice’ for patients.

“All NHS inpatient and outpatient appointments should be pre-booked by 2005, with two-thirds of all first outpatient appointments and inpatient elective admissions pre-booked by March 2004. This will give all patients a choice of a convenient date and time within a guaranteed period and help to reduce waiting times.”

It added:

“By the end of March 2002, more than five million patients had booked their appointment at a date and time of their choice.”

NHS Connecting for Health could argue that the two announcements were different: by March 2002 the five million patients who had been able to pre-book appointments were not offered a choice of hospitals, unlike the five million who have pre-booked appointments via the Choose and Book system.

But it’s unclear whether many GPs who use Choose and Book are making use of the “choice” element of the system. Paul Cundy, GP IT spokesman for the British Medical Association, said that Choose and Book would have had more support among GPs if it was a booking system only – without the choice. Many GPs prefer to book appointments with consultants they know will be the best choice for patients; and they say that patients would rather trust the recommendation of the GP.

Technologically Choose and Book is an advance on the much earlier National Booked Admissions Programme – but more than five years on, and after tens of millions of pounds has been spent on Choose and Book, it should be more advanced.

Choose and Book is a feasible national system; and it has smartcard access, audit trails and links to a limited variety of equipment used by GPs and hospitals. But it has large problems to overcome:

– some hospital patient administration systems cannot connect to it

– the system can be difficult at times for GPs to access

– appointment slots are sometimes unavailable to patients or GPs

– patient bookings can on occasions take weeks or months

– some doctors refuse to use it.

The Department of Health and its ministers are entitled to issue as many self-congratulatory press releases on Choose and Book as they wish. But they should wait awhile if they want to credibly claim that the scheme is a success.


NHS Connecting for Health: Five million referrals through Choose and Book

John Hutton, Health Minister’s statement to Parliament on pre-booked admissions

What is Choose and Book?

Pulse – open letter on Choose and Book

BBC online [2006]: 85% of doctors want a review of the NHS National Programme for IT

Choose and Book severity 1 incident

In support of Choose and Book