Wednesday, 19 August 2009

Choose and Book - whose choice?

I've had an encounter with the NHS's 'Choose and Book' system - and I have to say I am not thus far impressed. The idea is that it gives GPs the ability to book you an appointment directly, without doing a referral.

The reality is it's a major pain with a lot of margin for error.

I saw my GP in April, when he made me an appointment for my 2 year old daughter to see a dermatologist for an ongoing skin problem. The GP used the Choose and Book System.

I was initially made an appointment at the Finchley Memorial Hospital on 18th June 2009.

This was then cancelled by the hospital and I was given the date of 6th July 2009, this time at Barnet Hospital in Hertfordshire. This was going to be very difficult to get to. When I ‘phoned the 'Choose and Book' line I was told that I couldn’t choose which hospital to attend.

I couldn’t attend this appointment because I was having an operation that day. I was then sent another letter telling me this had been cancelled and that an appointment had been made on 20th July 2009.

I did not attend this appointment, but instead ‘phoned and cancelled it because my daughter’s skin had by this time cleared up.

My experience of 'Choose and Book' does not seem to be atypical according to anecdotes I have heard from other patients. I would like to know:

1. Why did I have to wait such a long time for the initial appointment?
2. Why did I get letters both confirming and cancelling the appointments, sent on the same day? This confused me as I didn’t know which letter was accurate.
3. Why was I sent out of London to see a dermatologist? I thought the point of Choose and Book was that you could CHOOSE. Is this not the case?

I've written a letter to the Chief Exec of Haringey PCT (now called NHS Haringey!)to get some answers. If anyone else has had a problem with 'Choose and Book' please let me know.

1 comment:

  1. You are not alone in having problems with Choose and Book. The system has become notorious for what some would call teething problems and what others would call fundamental flaws!

    A snapshot study conducted by UCL last year found that of over 100 patients surveyed, only 1 had received the level of choice that CaB promises to offer to everyone. Health professionals have also been critical, with the BMA coming out and saying that it actually limited choice for patients.

    Aside from technical problems in implementing it, there have been issues with some GPs resenting the fact that the system slows them down. Many have not actually offered patients the choice that they are supposed to have because this would be time-consuming and make them undertake a clerical role.

    Overall, the evidence suggests that it is working well in some areas but in others - for technical, organisational, or cultural reasons - it has been pretty ineffective.