Established in 2004, Choose and Book is now in use in every Primary Care Trust and provider organisation across the NHS in England including many independent provider organisations. This national electronic referral service gives patients a choice of place, date and time for their first outpatient appointment in a hospital or clinic.
Patients who use the system like it, valuing the certainty of a booked appointment at a date, time and place convenient to them and giving them greater flexibility in the way they are treated by the NHS.
Health Minister Mike O’Brien said:
'The right of patients to make informed choices about their care is enshrined in the NHS Constitution. We know that Choose and Book works well for many thousands of people every day giving patients much greater involvement in the decisions about their healthcare. When properly implemented, Choose and Book can provide significant benefits not only for patients, but also for referrers, providers and the wider NHS by delivering choice, certainty, security and reliability.'
The guidance entitled, ‘Responsibilities and operational requirements for the correct use of Choose and Book’ is supported by the BMA. It follows a BMA review of local experience around Choose and Book, published in January 2009, and provides greater clarity on the responsibilities of the NHS and clinicians.
Dr Chaand Nagpaul, GP, and member of the BMA’s Working Party on NHS IT said:
'When Choose and Book works well it can be enormously helpful to doctors, as well as patients, both of whom we hope will benefit from this guidance. We welcome the fact that the experiences of clinicians have been taken on board. It is crucial that trusts and PCTs meet the requirements set out in this document so that clinicians are appropriately supported when using Choose and Book.'
94 percent of GP practices now use Choose and Book regularly and in many parts of the country the system works well with Choose and Book now the standard method of referral.
At Whipps Cross University Hospitals NHS Trust a close partnership with NHS Waltham Forest has increased Choose and Book capacity for all specialities using the system and the hospital appointments team is recognised as one of the best in the country. Leading the way for the North East, GP practices in Sunderland Teaching PCT and City Hospitals NHS Foundation Trust have worked together to improve the patient experience by increasing patient involvement in the referral process and in turn driving up the quality of service provided.
In some localities Choose and Book has been adapted to fit different ways of working within local health communities which are not always in line with the way the system was designed to be used. The guidance will help organisations understand the importance of using Choose and Book correctly, in particular:
- Clinical staff should initiate and accept patient referrals with non-clinical staff fulfilling some of the purely administrative functions associated with the process
- PCTs and provider organisations must ensure that patients are offered choice in line with the roll out of the ‘Free Choice’ policy which came into force on 1 April 2009
- PCTs should encourage use of Choose and Book wherever possible by demonstrating its benefits rather than mandating its use
- Clinicians should be aware of their responsibilities when referring patients, especially when delegating these responsibilities to non-clinical staff to act on their behalf
- PCTs and provider organisations should ensure that computer hardware and software meet the required specifications for optimal Choose and Book usage and that appropriate IT skills and infrastructure are in place to support this
- If a provider organisation accepts paper referrals to named clinicians then they should do likewise through Choose and Book
- Provider organisations should ensure all clinicians providing services on Choose and Book are issued with NHS Smartcards and that they personally manage their referrals online
- PCTs and provider organisations should ensure that all relevant staff receive regular and appropriate training on Choose and Book.
Dr Stephen Miller, National Medical Director for the Choose and Book Programme said:
'Choose
and Book works best when it is used as it was originally intended, with
local health communities getting together, identifying the needs of
professionals and patients and adopting effective and efficient working
practices. Whilst a flexible approach to local implementation is
recommended, this should always be within the context of nationally
defined principles of best practice.'
'In preparing this
document, we have worked closely with clinicians, Strategic Health
Authorities and with the BMA who have all recognised that some of the
local ways of working to support Choose and Book simply don’t work for
patients and are often unpopular with professionals. We therefore very
much hope that local health communities will use this guidance to
review how they currently use Choose and Book and consider alternative
ways of working to help maximise positive patient and professional
experiences. Adoption of this guidance will enable patients wherever
they are in England to experience the same high quality access to NHS
care.'
Choose and Book is an effective tool when implemented correctly and supported by strong local ownership. We are continuing to work closely with the local NHS to increase the uptake of Choose and Book.