The NHS's new Choose and Book system, it says here, is a "national electronic referral service which gives patients a choice of place, date, and time for their first outpatient appointment in a hospital or clinic." Ever wondered why they're called "patients"? Well, in recent weeks The Register's Mystery Croaker has had the …
Choice? what choice?
Choose and book actually limits choice. It was previously possible to choose anywhere - GPs could refer arbitrarily.
Now the system locks down this decision making, limiting choice, making the process difficult for both patient and doctor alike.
Well, at least the NHS are trying! (albeit very!) Unless we go through with systems like these, then we'll never progress...just a shame that it seems to have had the development phase of a mosquito's lifespan and the testing of a nuclear bomb!
At least the helldesk operatives dont have power user or admin access!!!!
normally government IT projects run so smoothly, surely it must be a sinch to get all the hospitals talking to all the GP's within the entire country and then allow every patient to then log into a giant shared calendar system... ..oh hang on, that's the NHS properly broked then!
it reminds me of the old adage "to err is human, but to really screw up you need politics, computers and healthcare"
oh the humanity!
Not so Hasty
Lets not be so harsh. How many large companies have you worked for where you cant book meeting rooms without having to phone a receptionist?
So on the scale of the NHS thats one meaty system and will surely have teething problems. So good luck to them especially with the resistance to change which is surely at every step.
Give it a year and we probably wont know how we ever lived without it....
Well I think it's great
It worked very well for me. My GP referred me to have minor surgery in November last year, gave me my 'secure' login details and sent me on my way to book an appointment. Not only did it work flawlessly, first time, but it also allowed me to choose our local private hospital as it was aware of an agreement which existed between that hospital and my PCT. I had the op in December - couldn't be happier. Just thought someone should pipe-up when things actually work!
I used C'n'B not so long ago to book an appointment for my wife. The online service didn't work so we phoned, got through to a nice lady who booked us a suitable appointment in no time. It all went really smoothly.
Later, turned up at the hospital at the appointed time, and they had no record of my wife or any appointment.
Oh well ...
Choose and Book
Suprisingly I'm about to say something good about the system, my GP used the service to book me into the hospital with the shortest waiting list, in November.
I'm now at home resting from the op.
IT related however ... I wonder why they bother having medical notes if they can't be arsed refering back to them.
Why bother having a medical interview with a nurse, to be asked the questions again and again, I could have completed a questionare myself.
If they are about to computerise medical records - I don't see the point, if nobody can be arsed to pick up the notes at my foot of my bed. I can't see anyone would be arsed reading notes from a PDA etc etc. If I'm capable of remembering if I have any illness in the family - why waste the time of a nurse asking me these questions, when I'm going to be re-asked these questions again and again and again.
Good in Parts
I use choose and book daily as a doctor. It takes me longer to make an appointment for someone. It's less flexible for me and the hospital, and I have to meet a target on using it: frustrating when some days it just won't work. No-one on the health-care side finds it helpful.
Last year I had occasion to make my own appointment. No luck on-line. Call Centre helpful but apologetic. I phoned the consultant's secretary to sort it out.
Bottom line - nice for the public when it's working. much of the "choice" is illusory. It was mostly introduced as a tool to stimulate competition between health providers. It's poor value for money unless you look at it from a political angle.
(Now don't get me going on your medical records and the spine!)
white coat, door...
Medics are trained to take history and basically be suspicious of any source of information (does this blood test make sense? should I really remove the right kidney?). As the patient is most often the best data source it tends to come back to then.
If this does not happen then mistakes just keep being rewritten. When you take out the wrong kidney "This bit of the notes said 'left'" is a pretty poor defence when asking the patient would have found out it is the right.
This is really why medics are so skeptical of the big computer record. Most of the time we just don't see the point.
I tried it using Firefox but was told that it only works on IE. For some reason I couldn't even see when the clinic to which I was referred was open - just had to keep trying different days.
I eventually got an appointment than had a letter telling me it had been changed so the whole thing was pointless. I chose an appointment to suit me but the hospital changed it to suit them anyway.
I recently had to make TWO appointments via C&B, for unrelated things.
I live within a mile of hospitals that specialise in the two things I needed tested. My C&B forms offered me half a dozen places between 20 and 50 miles away...
THEN when I tried the net, all the hospitals turned out to be "not on the system yet".
And when I phoned the helpline, same answer. We can't do it they said, sorry, talk to your GP.
In the end I called the local hospitals direct, getting their numbers from yellow-pages. Appts sorted. No issues, except for the giggling when I mentioned C&B.
And then for WEEKS afterwards, the C&B system kept sending me 'reminders' that I had to book - with commentary to the effect that my failure to respond would be regarded as hostile, my notes would list me as a troublemaker, I'd be billed for wasted time etc etc. At least, that's how it felt.
Didn't work for me
I tried to use choose and book late last year. Firstly it didn't work on mobile safari ("We're working on supporting more browsers"). When I did log on I only had one choice of centre, and if I went into that it told me there were "No appointments available".
I phoned the helpline who told me to try again in 48 hours (which seems to be their standard line). 96 hours later there were still "No appointments" so I phoned back, to be told that there was nothing they could do and I just had to wait until someone noticed and put some more appointments on the system.
I eventually got an appointment by going through the receptionist at my GP surgery. They really didn't have anything good to say about choose and book.
Shame really, I like the idea, but the implementation sucks.
Choose & Book & IE7
I had fun implementing C&B last year for a private hospital group, I'm not sure about the public website but the 'hospitals side' of the system didn't like IE7, so if you're having teething problems with it on IE7 you might want to add *.nhs.org to the allow list of the popup blocker, as well as sticking *.nhs.org.uk in the Trusted sites..
Ken, I tried using firefox (on Ubuntu) and it rejected me - although enough of the site worked to give me the 'contact us' page. I sent them a message and they replied that it worked with the *latest* version.
I upgraded - and sent them an apology for me not keeping my firefox up to date!
[all for nowt as the clinic i wanted wasn't on CnB at all and I had to phone them direct]
Plus ca change
File on 4 (radio 4 doccy) did a program on the NHS IT project. They were put in touch with a GP who thought choose and book was super. Come the programme, he couldn't get it to work :-). That was almost two years ago.
(I feel El Reg should consider adding a Chocolate Teapot avatar)
In the private hospital whose DMZ I just built for this process, the CaB system runs an SQL query on the patient booking database, then pushes the open slots out to the NHS's N3 network where the front end systems live and the slots are added to the database. If those slots are then booked at the hospital the updates are queued unless someone else tries to make the same booking and then they are told about the unavailability.
It isn't too great but it DOES mean the NHS dont have to connect directly to each hospital's booking system every time an appointment needs to be made and it negates the NHS having a centralised booking system (which I think we would all hate even more!).
A Bit Dismal
I too have had experience of this. The GP said I had a choice of two hospitals, St. Nearby and St. Noparking. I was subsequently given a choose'n'book appointment sheet by her receptionist - who had the embarrassed air of someone who thought that they - or I - might regret this.
For a long time, there were no appointments available at either hospital and phone calls to choose'n' book informed me that the appointments were "allocated in batches" and I should just wait, or get my GP to escalate the issue with the consultant.
Finally a huge batch of available appointments at implausible 5 minute intervals appeared at St. Noparking, but still nothing at St. Nearby. Then, out of the blue I received a letter informing me that I had been allocated an appointment at St. Noparking. Subsequent discussions with the GP revealed that St. Nearby no longer has a clinic with that consultant, although it was still a choose'n'book option.
Although I remain a committed fan of the NHS, it could all be so much better - maybe just with a bit of joined-up thinking.
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