DH gives another push to Choose and Book

GPs will have to use Choose and Book or face “potentially labour intensive methods” for booking appointments under new plans outlined by the Department of Health.

A new consultation paper – Liberating the NHS: No decision about me, without me – says the DH is also looking at developing the e-booking system and NHS Choices so that patients can book directly through C&B.

The document says the DH is “working to maximise use of Choose and Book so that more referrals are made through it and more patients are given an opportunity to make choices over their care and treatment.”

“Where Choose and Book is not being used, formal requirements to support greater choice for patients will have to be met by alternative, potentially labour intensive, methods,” it says.

EHealth Insider reported in March that C&B usage had fallen from a high of 57% to just 50%.

The paper says data showing utilisation rates by practice for the e- booking system will be published online. This will allow patients and the local public to “exert pressure” in areas where C&B usage needs to be increased.

Hampshire GP Dr Neil Bhatia described the plan as a “sad and somewhat desperate” attempt by government to ramp up usage of C&B.

“It speaks volumes when you have to make threats for people to use software,” he said. “If people aren’t using it, it is because they don’t want to, or it’s not very good.”

Dr Bhatia said the “labour intensive methods” referred to would just be a continuation of what practices already do – in other words, faxing, emailing and posting documentation.

“These are all hollow threats that the DH hopes will make a few practices say ‘ok let’s do it then’, and figures will go up.

“But the figures have stagnated because those who want to use it are using it and the rest don’t have an interest in it,” he argued.

Dr Bhatia tried using C&B some years ago and found it “dreadfully time consuming.”

He said it was impossible to fit using the service into a ten minute appointment and that it prompted many complaints from patients who were unable to book appointments.

The idea that practices would have to ring around a lot of hospitals to find an appointment was also unlikely because “very few” patients want to exercise choice and are happy to take the advice of their doctor, Dr Bhatia added.

Under the new standard contract set out in the consultation paper, providers would be required to: list all services eligible for patient choice on C&B; accept all clinically appropriate referrals made through C&B; publish information needed to support these choices; and work with commissioners to “ensure that service users are not delayed or inconvenienced by insufficient appointment slots being made available to Choose and Book.”

The consultation paper says that diagnostic tests which are not carried out as part of a consultant-led first outpatient appointment should be listed on C&B and be directly bookable by patients, provided this is clinically appropriate.

The requirement to provide direct access to diagnostic tests will be set out in standard contracts. Over the coming year, the DH will set out which tests will be the priorities for inclusion on the system from April 2013.

These could include high volume services such as audiology, non-obstetric ultrasound, gastroscopy and electrocardiograms.

All direct access urgent referrals, such as cancer two week waits, will be exempt, but providers could continue to use C&B to list these services and allow direct bookings to them, the paper says.

Commissioners would be required to ensure that this choice is available to all eligible patients. The document adds that a key obstacle to using the electronic system for booking diagnostic imaging services is the incompatibility of the existing radiology information systems with C&B.

“Work is ongoing to identify how best to improve the compatibility of the systems with a view to including imaging services on Choose and Book,” it adds.

Consultation on the new plans runs until 20 July.

As part of its exclusive survey of CCG IT and information plans, EHI Primary Care asked GPs and emerging CCG leaders about their plans to use national services like Choose and Book in the future. Read more about the survey on EHI Primary Care.