Choose and Book is an essential feature of the government's much vaunted but massively overspent NHS IT programme Connecting for Health.
Choose and Book is already over budget and behind schedule. It is a hopelessly designed system which is almost universally unpopular with doctors and patients. To date, only 13% of GP referrals to hospital are being made on the system, against a target figure of 80%, and this despite the GPs being given financial inducements to use it. Some 30% of patients who the GPs think they are referring never manage to complete the complicated booking process and are just lost in cyberspace.
Most remarkable of all is the extraordinary cost of he scheme; at present prices, over the 10 year lifetime of the IT contracts it will cost a remarkable £125 to make every patient appointment. That's not the cost of the treatment, that's just the cost of making the appointment.
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Choose and Book referrals have a further disadvantage in that the GP can provide only a very limited case history; it is not possible, for example to attach copies of previous correspondence, histopathology reports, ECGs, etc
And from the hospital viewpoint: the system is booking people into inappropriate clinics. Adults sent to children's clinics. Patients prepared to travel "in the county" being sent out of the region. Children referred to "Dear Paediatric Cardiologist" being sent to the hospital that doesn't have such a doctor...a couple of miles from the one that does. Babies with hip problems turning up in general clinics, where the necessary scans cannot be carried out, when there is another clinic in the same trust that offers a one-stop service for this. The list goes on and on. This is bad for patients: those sent to the wrong clinic have their time wasted, and have to wait longer for the appropriate appointment. Those who are being sent to the right clinic are potentially having to wait longer, as the appointment they migh have had is filled by someone for whom it is useless. Oh, and it all costs extra money, which currently could be used for something far more useful for patient care.
Following our discussions over the phone. I can now clarify a few issues. The projected cost per patient is £1.08p over a ten year period. This takes into account the initial core contract extrapolated to ten years. (in contrast to the £125 that you have quoted. 80% of GP practises are used the system last week, 87% in month. There was a 37% total utilisation of the system last week. I can also confirm that patients are not lost in the system as they remain on GP worklists until their appointments are confirmed, in stark contrast to the potential for loss using our postal system
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