NHS struggles to meet patient choice targets

Politics rather than technology blamed for lack of Choose & Book referrals

Use of the electronic bookings element of the £6bn NHS IT programme is falling far behind government targets, but experts say politics is more to blame than technology.

To qualify for a £100,000 incentive, Primary Care Trusts (PCTs) should have been processing half of the nine million first-time referrals from GPs through the electronic Choose & Book (C&B) system by this autumn.

But just 8,130 appointments have been made through C&B.

The target for C&B was always over-ambitious, says Dr Paul Cundy, spokesman for GP computing at the British Medical Association.

‘It is ridiculous to expect to create and implement a brand new system in 10,000 GP surgeries, among 45,000 GPs, for nine million referrals a year, in the space of 18 months,’ said Cundy.

But changes to the requirement are more to blame, he says.

Initially, ebookings was designed to be just an electronic facility for making appointments. But with the development of the government’s choice agenda for public services, it needed to offer patients four booking options.

‘The danger is that the choice agenda is adversely colouring the technology agenda because if you took choice out the situation would be completely different,’ said Cundy.

To speed up availability, a version of C&B has been offered to GPs through a web site, but is not integrated to GPs’ systems. GPs are enthusiastic about the concept of ebookings, but the online C&B product on offer is not yet good enough, says Cundy.

‘Using the web version rather than dictating a letter offers no benefits whatsoever,’ he said.

Emis UK, software supplier to 5,300 GPs’ surgeries has only quoted to 3,131 of its practices for upgrading their systems to integrate with C&B.

‘The delays have been more about errors of judgment in the management structure because C&B implementation was procured in a piecemeal way rather than centrally,’ said Emis deputy managing director Sean Riddell.

A spokesman for the national programme says it is asking Strategic Health Authorities to ensure PCTs are either on track to have C&B fully implemented by the end of December or are putting in place manual systems to provide patient choice.