New version of C+B supports ‘extended’ choice
- 2 May 2006
GPs are expected to offer patients the option to choose from a national menu of NHS hospitals and private providers from this week either manually or via Choose and Book software, according to latest Department of Health (DH) guidance.
A new version of the Choose and Book software has been issued alongside guidance from the DH spelling out the department’s policy on ‘extended’ choice at referral. The guidance emphasises that GPs must offer patients the chance to choose from the national menu either manually or via version 3.0 of Choose and Book which is being implemented this week. It says this is in line with the directed enhanced service (DES) for choice and booking.
The guidance says: “While many patients may be content to choose from local PCT-commissioned services, GP practices will be expected to tell patients that the new national menu also exists and to discuss clinically appropriate options available.”
Implementing extended choice could add to GPs’ workload as large numbers of GPs are predicted to start using the existing system which until now has been focused on offering four PCT-commissioned options for patients to choose from.
Dr Richard Vautrey, deputy chairman of the BMA’s GP committee and its lead on IT issues, said the committee was aware extended choice would be introduced but first wanted to monitor the impact on the existing system as practices work to meet the first target for the DES for 25% of referrals to be through Choose and Book in June.
He told EHI Primary Care: “Practices have only really just started getting to grips with Choose and Book and June will be a great test of how robust the Choose and Book system is overall. If it’s shown to be OK that will give practices greater confidence to go on.”
All 32 NHS foundation trusts will be offered the opportunity to add acute services to the national menu immediately and the 15 first wave independent sector treatment centres (ISTCs) will be able to add information on services they have contracted with local PCTs. First wave ISTCs will be invited to load services on to a national menu once a re-charging model has been agreed to enable other PCTs to refer patients to them. Other private providers who want to add services on to the national menu will be approved to do so through ‘extended choice procurement’ due to be complete by summer 2006.
The guidance says patients will receive extra information to help them choose from national providers where appropriate from a supplement to a ‘Choosing your Hospital’ booklet and via www.nhs.uk. It says PCTs should target local resources to help patients with extended choice with suggested methods including use of practice staff, use of specialist patient care advisers, advice about the Choose and Book Appointments Line or use of voluntary organisations.
Another concern of the extended choice system is that it could deny patients the choice of appointments at their local provider. To create equality between providers on the national menu the DH has insisted that PCTs and providers must give priority to meeting the conditions of any local contracts and commissioning agreements in preference to national menu activity. Providers on the national menu must also ensure that services are available both via Choose and Book and via manual booking. Providers are not allowed to turn down referrals on the grounds of the location of the PCT.
Prices will be set at the national tariff to avoid ‘spot purchasing’ of common elective procedures and providers will be expected to avoid subcontracting work.
The DH says more technical guidance on extended choice, including methods for monitoring and managing providers on the national providers’ menu, is to be published in June and September.
Connecting for Health says the Choose and Book system was down over the weekend so that version 3.0 could be implemented in time to go live today (2 May).
Other changes in version 3.0 of the Choose and Book software include the addition of estimated waiting times for all services, ability to indicate need for transport or an interpreter and clearer displays of information within some of the screens.
A statement from CfH says practices and trusts have already been told about the introduction of version 3.0 of the Choose and Book software. It adds: “NHS Connecting for Health has advised that current users of Choose and Book should familiarise themselves with the new functionality ahead of 2 May, if they wish to make the most of the changes.
"GPs or practice staff have been informed that they should contact their primary care trust (PCT) if they wish to arrange formal Release 3.0 training. Likewise, trust staff should contact the relevant Choose and Book/IT training lead within their trust."
Links
Health department guidance on extended choice at referral