NAO warns of delays and risks to NHS Choose & Book project

The National Programme for IT in the NHS (NPFIT) made just 63 live electronic bookings on its flagship Choose & Book project by...

The National Programme for IT in the NHS (NPFIT) made just 63 live electronic bookings on its flagship Choose & Book project by the end of December, against a forecast of 205,000.

News of the shortfall emerged as the public spending watchdog warned that a key government target to offer patient choice in the NHS by the end of 2005 could be at risk if delays continue to the NHS IT project.
The National Audit Office, in a report on patient choice, today (19 January) warned that Choose & Book, the online booking system project would not hit its target of 100% availability by the end of 2005.

Edward Leigh MP, chairman of the House of Commons Committee of Public Accounts, said, “Plans to reform the NHS have been dealt a blow. There has been abysmal progress towards delivering electronic booking of hospital appointments from GPs’ surgeries by the target date of December 2005.

“By the end of last month, only 63 live electronic bookings had been made, against a forecast of 205,000, at an average cost so far of £52,000 a booking. This is against a background of some nine million referrals each year.”

The NAO report said that some progress has been made but  also pointed out that little had been done to engage GPs, the clinicians at the centre of the process.

NAO research showed that half of GPs knew little about their role in patient choice and around 60% had some negative feelings about it. This reflects research carried out for this publication by Medix, in February, August and October 2004, which highlighted GPs lack of engagement with the NPfIT.

Meanwhile, the Choose & Book systems will not be universally available by December 2005. Under current plans, only 60% to 70% of the NHS will have access to the system by that date.

John Bourn, head of the NAO, said choice in referral could bring benefits to patients but warned about risks to the project.

“The Department of Health must take urgent and effective action to inform and engage with GPs about the new arrangements. GPs’ support may be hard to secure and indeed choice will be hard to deliver successfully by the end of 2005 if the electronic booking system is not up and running by then,” he said.

PAC chairman Edward Leigh emphasised the point. “There is a very real danger that patient choice will be undermined if full electronic booking is not available,” he said.

“GPs around the country are already sceptical about patient choice: 60% are negative towards patient choice including even those who know most about it. I want to see the Department put every effort into convincing them. Nothing short of an easy to use, fully functioning electronic system for booking hospital appointments will persuade them that choice has a future.

Responding to the NAO health minister John Hutton said there had been an intensifying effort since last autumn to win GP support for  Choose & Book.

"The report acknowledges that Primary Care Trusts and GPs are moving in the right direction to deliver choice by the end of this year. As we set out in the Department of Health document Choose & Book, published in August 2004, this will be offered mainly through IT but also other means, such as phone booking.

"We have implemented the choice IT programme in stages. First, we procured the equipment, second, we made sure it worked, now the challenge is to roll out the service across the NHS.

"More than 2,500 GPs have already been involved in developing systems to support choice and booking, and this engagement will increase during this important next stage of implementation," he said.

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