Clinicians' privacy concerns belie official line

Officials on the national programme for IT in the NHS have defended the "Choose and Book" system after claims that initial...

Officials on the national programme for IT in the NHS have defended the "Choose and Book" system after claims that initial implementations have run into problems.

The system is designed to allow GPs and their patients to book hospital appointments online, and be given a choice of times and locations.

But the national programme has admitted that although the system went live in July, there have been few appointments booked using it. Asked whether the number of appointments booked on the system was less than 20 by the end of September, a spokesman said that the number booked was "relatively low".

"An integrated Choose and Book service is available. It has been tested and it works," said the spokesman. "It has not yet been made widely available to GPs and that is in line with carefully developed implementation plans under which there will be a gradual roll-out according to an organisation's readiness to implement. Feedback from both GPs and patients has been very positive."

But a memo seen by the Sunday Times tells a different story. It was written by a project manager in Yorkshire, where GPs are among the first in the UK to use the Choose and Book systems Dated October 2004, it is addressed to the Barnsley Primary Care Trust and outlines the state of play on the local project

It said clinicians think the system would be impressive if concerns can be addressed. As yet "no live bookings have taken place" because clinicians have reservations about the performance, security and other aspects of the system.

"Implementation at Barnsley is currently on hold until sufficient reassurances have been made to convince the project team that all aspects of concern regarding the confidentiality of patient information have been approved at highest level," the document said.

Concerns include a worry that a wide range of people with smartcard access can amend a patient's record and unplanned downtime of the "data spine" which will hold summaries of electronic patient records.

A spokesman for the NPfIT said, "It is entirely to be expected that there will be issues and concerns raised by early adopters and we are working constructively with them to address the points they have raised. Indeed, it is a sign of a well-managed programme that we are implementing in a gradual way so that the lessons learned in the early adopter sites can be applied elsewhere as the roll-out progresses."

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