GPC says patients should call C+B when no slots available

GP representatives are recommending that practices tell patients to ring the Choose and Book appointments line if they are no slots available at their chosen hospital.

The advice from the British Medical Association’s General Practitioner Committee is designed to take advantage of a Department of Health instruction that The Appointments Line (TAL) must forward appointment requests direct to hospitals where there are problems with slot unavailability on Choose and Book.

The GPC says that if GP practice staff do not think it is appropriate to ask a particular patient to call TAL, the staff may offer to call TAL on behalf of the patient with the patient present.

Dr Richard Vautrey, a GP in Leeds and a GPC negotiator, said patients should be given a printed copy of their appointment request details and advised to contact the TAL if a practice had found no slots were available on Choose and Book.

He told EHI Primary Care: “The financial difficulties facing PCTs and trusts and the desire to hit national targets is affecting slot availability and we are concerned that as the financial year end approaches there will be more difficulties for local patients trying to access their local services.”

A letter from the DH to strategic health authorities, which came into effect at the beginning of this year, says that “in the exceptional circumstance” that a patient calls the TAL and no slot at the chosen hospital is available, TAL should forward the appointment request details to the hospital so that the hospital can liaise directly with the patient to arrange their appointment.

The letter adds: “It is essential that Trusts treat appointment requests forwarded through this process as they would an urgent referral. For the purpose of waiting times, the clock start date for providers will be the date that the patient has experienced slot unavailability when they have called TAL.”

The GPC has told local medical committees that in some circumstances where it is still not possible to book an appointment, providers may contact the GP practice to ask they forward the referral letter manually and cancel the appointment request on the Choose and Book system.

Its advice adds: “This may occur where, for example, there is an ongoing technical issue affecting the interface between a provider PAS and the Choose and Book system.”

The GPC advice says the DH are identifying those appointment requests that are cancelled as a result of the slot unavailability processes and will be advising PCTs of these numbers for individual GP practices so the numbers can be included in the Choose and Book figures for the purpose of the choice and booking directed enhanced service (DES).

In separate advice the GPC has told practices that it is aware that many practices in many areas are suffering from frequent failures of the Choose and Book system and collapses of the N3 network connections and that, therefore, not all practices will hit the target for the DES.

It says that if, by the end of the financial year, a practice cannot implement a programme due to circumstances outside its control, practices will be guaranteed a pro-rata payment for the work they had completed.

It adds: “This includes system failure or the inability to access the system due to national problems. Practices in this situation should raise this issue with their PCT. Additionally, failure of the Choose & Book system should not affect the aspiration payment if a commitment to use the system has been demonstrated. “

At least one hospital and one PCT have begun to insist that referrals must be made through Choose and Book, as reported by EHI Primary Care. But Dr Vautrey said the GPC believed it was unlawful for PCTs and hospitals to do so. The GPC is taking further legal advice on the issue.

Dr Vautrey added: “No system is 100% foolproof and it’s completely inappropriate to insist on Choose and Book as the only vehicle for making referrals for patient safety reasons more than anything else.”

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