PAC doubts e-referrals success

The Commons’ public accounts committee is “sceptical” about NHS England’s ability to fully utilise the e-referrals service.

In a report on 'NHS waiting times for elective care in England', the  PAC  says that following the introduction of Choose and Book, which has had a poor uptake among GPs and secondary care providers, it is doubtful of the success of the new e-referrals service.

It says that the Choose and Book service, which was intended as one of a number of new, digital services to make the NHS more convenient, “has been a missed opportunity to improve patient care and data quality”.

Choose and Book was launched by the former Labour government as an attempt of introducing the NHS to an ‘airline-style booking’ system, but the deployment of was significantly delayed, and usage has stalled at around 50%.

Speaking at the launch of the report, PAC chair, Margaret Hodge, said: “The online Choose and Book appointment system has been underused by both patients and healthcare professionals.

“We are sceptical about the NHS’s ability to ensure that the replacement system, e-referrals, will be used any more fully."

EHI reported last month that the e-referral service, which will be supplied by BJSS, is due to go live in November this year, and will be based open standards.

The new service aims to make it easier for patients to book, track and manage their hospital appointments.

NHS England is considering making use of the new e-referrals service mandatory as well as introducing an incentive and penalty system to ensure NHS providers use the service. The PAC report says that the centre must be clear on how it plans to imrpove uptake of the service.

“To realise the full benefits of e-referrals, NHS England must develop clear plans for how it intends to build up confidence in and utilisation of the new system,” it says.

The  report also says that it cannot be sure that the waiting times for referrals published by NHS England is accurate.  

This comes as the National Audit Office reviewed cases at seven NHS trusts and found that nearly one third of cases were not documented and that 26% had one or more errors.

Hodge also highlighted that the public lacks confidence in trusts’ ability to meet the 18 week waiting time target, and to record waiting time information.

“Trusts are struggling with a hotchpotch of IT and paper-based systems that are not easily pulled together, which makes it difficult for trusts to track and collate the information needed to manage and record patients’ waiting times,” she said.

By the end of the year, NHS England will have to simplify its guidance on waiting times.

The PAC report also recommends that NHS England should work with Monitor and the NHS Trust Development Authority to agree clear responsibilities and a timetable for “obtaining assurance that trusts’ systems and processes for monitoring waiting lists produce consistent and reliable data.”