Choose and Book fails to offer choice

Choose and Book failed to deliver its promise of choice of hospital, time and date of appointment, a newly-published study shows.

Researchers from University College London’s Centre for Health Informatics and Multiprofessional Education (CHIME) questioned more than 100 patients referred to Hillingdon Hospital, London, either via Choose and Book or using a paper-based system.

The researchers found that 66% of those referred via Choose and Book were not given a choice of date for their outpatient appointment, 66% said they were not given a choice of appointment time and 86% reported being given a choice of fewer than four hospitals.

However a spokesperson for Connecting for Health told EHI Primary Care that the study was not a reflection of present experiences. He said: “Today Choose and Book has had more than 10 million bookings and the UCL study of 104 patients from a single hospital, two years ago, does not reflect the experience of most users.”

The study was conducted between May and August 2006 with patients identified by Hillingdon Hospital’s patient administration system and interviewed at the hospital while waiting for their outpatient hospital.

Dr Henry Potts from UCL’s CHIME oversaw the study and said it was clear from the results that patients were not experiencing the degree of choice that Choose and Book was designed to deliver.

He added: “This may be only one hospital, with results taken in a transitional period, but we believe this could be typical of the national picture.

“It is striking that nobody, up until to this point, has actually asked patients about their experience of the system. These results show the reality of what’s happening on the ground, surely vital when it comes to measuring to what extent this is working or not. This study also raises many wider questions such as what patients understand by choice and, indeed, whether they actually want choice.”

The data showed that 63% of patients were not aware before their GP appointment that they were entitled to choose to which hospital they were referred. The researchers questioned 47 patients who had been referred via Choose and Book and 57 who had been referred using a ‘partial booking’ system which meant the referral was sent from the GP on paper and the hospital then wrote to the patients asking them to ring and make an appointment.

In comparison with the partial booking system patients using Choose and Book did report being offered a greater choice of hospital but were no more likely to be offered a choice of time or date of appointment.

Those who had booked their appointment online or via a call centre using Choose and Book were also more likely to report being offered choice than those who had booked their appointment via Choose and Book using their GP surgeries.

The spokesperson for CfH added: “Any patient receiving routine elective treatment is now able to choose from any NHS approved hospital provider in England. A part of this, the electronic referral system, Choose and Book, allows patients to choose their outpatient appointment according to their own priorities – whether that is the first available date, the hospital closest to their home, or fitting their appointment around their family or work commitments.

”Recent major surveys on patient choice and primary care consistently show the number of patients using Choose and Book and being offered a service continues to steadily increase. Choose and Book is used for around 50% of all GP referrals to first outpatient appointment. 98% of GP practices have Choose and Book and currently 92% are using it for referrals."