Specialists dispute keyword changes for C+B

A dispute between specialists and the Department of Health over use of keywords for Choose and Book clinic types has led the British Society for Rheumatology (BSR) to recommend that consultants do not populate their directories of services.

Dr Andrew Bamji, the society’s president, said that he and other members spent the last year drawing up a list of 177 keywords mapped to clinic types after a request by NHS Connecting for Health.

He told EHI Primary Care: “We submitted it and we thought we have done a good job there but then discovered by chance that the lists that we had submitted were not the lists that were published.”

Dr Bamji claims that another group within CfH, not including specialists, had reviewed the list, cut the keyword list down to 140 and changed some clinic types.

He said: “We were taken aback. Our part of CfH had no knowledge that the keywords were being revised by this other group. We have put an enormous amount of time into it and then to have someone else fiddling with it and not even be told about the changes is not helpful.”

Dr Bamji says the discovery of the changes led the society to alert other speciality groups who had also drawn up keyword lists mapped to clinic types as part of CfH body called the Specialist Association Reference Group.

He added: “They found that they also had had changes put in to their lists that they were not happy about.”

Professor Angus Wallace, who leads the specialties on the group, told Hospital Doctor magazine that specialties might pull out of SARG as a result of the problems.

However Dr Bamji said his group was determined to stay involved and try and resolve the problems if possible but so far had been unable to come up with a satisfactory outcome.

In the meantime a statement issued after the BRS’s council meeting last week says: “BSR has been working with the Choose and Book Specialty Working Group for the last year defining clinic types and key words. We are therefore disappointed that changes have now been made to the key words and clinical types without consultation. We are further concerned that the changes have resulted in errors which means that BSR in now unable to endorse the list.

“We are continuing our discussions with the Choose and Book team and hope this situation can be resolved satisfactorily. In the interim we recommend that consultants do not attempt to populate their local directories of service and advise their acute trust managers that they should not do so either.”

A spokesperson for the Department of Health said: “The current version of the Directory of Services (DoS) is our first attempt to bring some national consistency to clinical language of finding services in Choose and Book (CAB). We have acknowledged that communication with the specialist advisors and reconciliation of their advice with that of GPs, specialist DoS managers and commissioners has been problematic and have been working on a long term strategy to improve the situation.

“The CAB Speciality Working Group held an extremely constructive workshop on the 18 October which included members of the Specialist Association Reference Group as well as clinical data and standards specialists, GPs and members of the CAB team in DH and CfH. This workshop endorsed a consensus about the strategic direction of the work being done to help GPs find services effectively and incorporate the opportunities afforded by the availability of SNOMED clinical coding in the National Programme for IT next year. The workshop also agreed the principles of a more effective strategic arrangement for working with SARG.

"The DH CAB Specialty Working Group do not see any serious difficulty to resolving the concern expressed by BSR and would welcome the opportunity to discuss the issues with them.”