Updated: Survey slams NHS computerised booking system

The new NHS computerised booking system is failing to deliver sufficient choice to patients, according to research carried out by University College London.

UCL surveyed 104 patients referred to Hillingdon Hospital who had used the Choose and Book system.

Cerner, in partnership with Atos Origin, developed and implemented Choose and Book as part of the National Programme for IT (NPfIT), the tech upgrade run by NHS Connecting for Health. The Choose and Book system seeks to provide patients with choices regarding the time, date and place of their first outpatient appointment via a computerised booking system.

The survey found that 66 per cent of respondents said that they were not given a choice of date for their outpatient appointment.

A further 66 per cent of patients said that they were not given a choice of appointment time and 86 per cent said that they had been given a choice of fewer than four hospitals.

Meanwhile, 32 per cent reported not being given any choice of hospital at all.

The study also revealed that 63 per cent of patients had not been aware before their GP appointment that they were entitled to choose which hospital they were referred to. Those who had booked through their GP surgeries appeared to experience less choice than those who had booked online. Patients who had used online booking did report some technical difficulties.

Patients using the old booking system found that they were not given the same level of choice of hospital as those who did use Choose and Book. However, Choose and Book patients did not report being offered a choice of time and date any more frequently than those who had used the old system.

Shockingly, the survey found that only one patient reported that they had been offered a choice of four hospitals, appointment date and time, which is the desired level of choice that Choose and Book was designed to offer everyone.

Dr Henry Potts of the UCL centre for health informatics and multiprofessional education (CHIME), who oversaw the study said that said it was clear that patients were not receiving the degree of choice that the Choose and Book system was striving for.

"We were very surprised by our report, we found lots of criticism and we hadn't expected the problems we foundpeople said that the choices they were offered weren't real choices, such as being offered treatment at hospitals that are a long way away, which isn't really a choice.

"It is striking that nobody, up until this point, has actually asked patients about their experiences 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."

Asked as to a reason why the computerised system was failing patients, Dr Potts cited communication, or lack of, as a contributing factor.

"This system was introduced with not much planning. With Connecting for Health there was not much consultation with primary care staff and consultants."

Cerner and Atos Origin did not return requests for comment by the time of publication.

A Connecting for Health spokesman said: "Choose and Book has had more than 10 million bookings and the University College London (UCL) study of 104 patients from a single hospital, two years ago, does not reflect the experience of most users."

"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 per cent of all GP referrals to first outpatient appointment. 98 per cent of GP practices have Choose and Book and currently 92 per cent are using it for referrals."