President of Royal College of Surgeons attacks Choose and Book

John Black, president of the Royal College of Surgeons, says the Choose and Book system “purports to offer greater patient choice” but “has had the opposite effect”.

Black’s comments will not make it any easier for NHS Connecting for Health to persuade doctors to use Choose and Book. Many like it and some refuse to use it. A few doctors complain that they find it difficult to finalise a booking on the system because of technical problems. But Black’s criticisms are of the way the system works rather than the technology.

Black told BBC Online:

“Using the latest technology to increase the efficiency of the health service and measure how patients’ lives are improved is vital. But this must be sensitive to the individual patient and must retain personal professional judgement.

“The current system in the NHS is forcing patients and doctors apart and I believe the delivery of care is poorer without those personal relationships. “

But responding to Black’s comments Whitehall officials have pointed to a blog post by Helen Evans, of “Nurses for Reform” who calls on doctors to embrace Choose and Book.

Black told the BBC that GPs needed to maintain direct professional relationships with local hospital doctors to be able to select the right consultant for each patient, based not just on the type of operation and technical competence, but also on personalities.

This cord between GPs and surgeons has been cut by the Choose and Book system, which he said purported to offer greater patient choice but which has had the opposite effect.

Choose and Book is one of the four main pillars of the NHS’s £12.7bn National Programme for IT [NPfIT].  

When GPs make a Choose and Book appointment for a patient, they are dependent on the Choose and Book software itself, the N3 broadband network, several components of the BT-supplied data spine, and many components of local GP and hospital systems all working well.  A failure in any one of the applications can result in the Choose and Book transaction not being completed.

The Department of Health’s statement on Black’s comments:

The Department of Health said: 

“Providing the public with the information they need to make informed choices is a vital part of the NHS constitution launched today. Doctors recognise their vital role in this and the benefits to patients of involving them more in decisions on their care.

“GPs’ knowledge of local services will always be invaluable, but the public, who pay for the health services, expect and welcome choice over their care.

“Rather than forcing patients and their doctors apart, Choice allows patients to be active participants in their healthcare alongside the guidance of their GP. Choice has also helped drive up standards across the NHS in England.”


Personal touch lost in pass-the-patient – BBC Online  

RCS President attacks Choose and Book – Kable

John Black profile – The Times, 2008

I support Choose and Book says GP – Pulse magazine  

Why we must Choose and Book – Nurses for reform


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What nonsense!

Patient choice is key and the ability of patients to influence the direction of care episodes is paramount to the future of the NHS. It is vital that patients have the ability to choose where and by who follow up procedures and continuity of care is provided and that they are given appropriate information to make an informed decision.

I find Mr Blacks comments on the ability of the general public to make informed decisions about their own care to be insulting at best but this is of course not entirely surprising from a group of people who seem to think that they and only they know what is best for individuals... Far be it for the lowly patient to have any say in their own care...

For too long, patients have been hamstrung by outmoded surgery times which benefit doctors and not patients, lack of choice as to which surgeon to choose or hospital to be treated at and so forth. Programmes such as 'Choose and Book' give patients the ability to influence their own care and have a say in its direction.

Mr Blacks comments are very similar to those of GPs purportedly concerned about so-called 'Darzi Centres'. The concerns are dressed up as concerns about continuity of care but are in reality about the GPs practices 'bottom line'. I for one welcome such centres which allow me as a patient to get appointments at times to suit me. 'Choose and Book' provides a similar ethos and I for one welcome it.

I would like to come to Mr Black's defence. Mark has presented his comments in an articulated, educated way. Not all patients are able to do this - blind,old,etc are the very people who are really disadvantaged/suffering trying to use the C&B system which in my opinion is unfit for purpose.I raised this very matter at a SHA meeting in the hope that the Chief Executive responsible for its creation would hear first hand the difficulties these patients are having. Sadly she refused. Patients are being used as GUINEA PIGS for system testing which was never the intention.The C&B simply DOES NOT WORK evenly and is widing the inequalities gap.

It is time to scrap all this professional protectionism. Of course consumers can decide if they are given access to information and brands. I know nothing about how cars work but I know the brands I trust. Same with computers, lifts and dozens of other things I use on a daily basis.

It is time that doctors, nurses, hospitals and pharma companies are all encouraged to advertise and compete. We have to embrace commercial and professional free speech. We have to privatise all health and social care provision. And we have to empower consumers - particularly the poor and disadvantaged who are often at the bottom of the NHS's statist pile.