NHS to dump £356m patient booking system

New e-Referrals system could be made mandatory for GPs, says NHS England

The NHS is to replace a patient booking system that has cost the organisation £356m from its inception to March 2012.

The Choose and Book system is an online booking service for patients and healthcare professionals that was introduced in 2004. But its use by GPs is "variable", according to a report on NHS waiting times published by the Public Accounts Committee (PAC).

The committee labelled the system "a missed opportunity to improve patient care and data quality", stating that it had a chequered history and was underutilised, meaning that annual savings of up to £51m are being missed.

It said that some hospitals, such as Northampton General Hospital, had made most if not all of its appointments using Choose and Book, but compared this to Homerton University Hospital, which said it had a significant number of referrals to it that were made on paper.

NHS England said that many GPs like Choose and Book, and that half of referrals are received this way. But not all appointment slots are available through the system, which limits its usefulness.

The organisation is now replacing it with the NHS e-Referral system, which will be more widely available to healthcare professionals including physiotherapists and opticians, for example.

But after the underutilisation of Choose and Book, the PAC asked NHS England what was being done to make sure that e-Referrals does not suffer with the same problems.

In response, the NHS claimed that it was running trials with GPs with a view to making use of the system mandatory, and looking at options for incentives or penalties to encourage uptake. However, it failed to encourage GPs to use Choose and Book with financial incentives, and so it is unclear how it would manage to encourage them with the same incentives this time.

According to the Guardian, NHS England had said that the system would use different technology, but did not disclose how much the scheme would cost.

Meg Hiller, a Labour MP and member of the committee, said that the abandoning of Choose and Book was "another NHS cock-up".

"A system designed for use by GPs but only used by half of them... has been quietly dropped, so quietly that even most of the NHS seems unaware," she said.

Choose and Book is one of many recent IT failures within the NHS. The National Programme of IT (NPfIT), which was set to include a patient record system, suffered several delays before being scrapped. Last year, the PAC said that NPfIT had cost the taxpayer nearly £10bn.

NHS England is also working with the Health and Social Care Information Centre (HSCIC) on the much-criticised care.data programme, which is a centralised patient record database that could enable pharmaceutical companies, researchers and other organisations to tap into anonymised patient data.