NHS England plans to have a redeveloped Choose and Book service operating by the end of this year.
Industry leaders are concerned that the re-platforming of the electronic booking service is being rushed to meet an impossible timescale.
NHS England’s new business plan for 2013-14 – 2015-16, ‘Putting Patients First‘, says it will have a new NHS e-referrals service operational by December 2013.
It says the re-launch of Choose and Book is part of the ‘Paperless NHS’ programme and aims to make electronic referrals “universally and easily available to patients and their health professionals for all secondary care services by 2015."
The plan adds that all referrals will be done electronically by March 2017.
The contract for delivery of Choose and Book is with Atos Healthcare and runs out in December 2013, with no further options for extension.
A Department of Health market engagement exercise document released last August said it was re-procuring Choose and Book and wanted to remove the use of Cerner Millennium so it would own the intellectual property for the system’s functionality.
The current service is built on an implementation of Cerner’s Millennium product, using the person and scheduling modules.
Head of healthcare at Intellect Jon Lindberg said NHS Connecting for Health staff met with industry representatives last August to set out their vision for the service.
The idea of using open application programme interfaces had broad support from industry, but there was a problem with timescales.
“Even in August, industry was quite cautious around achieving this almost redevelopment of the Choose and Book system to go live by December this year,” he explained.
Their recommendation was to break it up into two procurements. The first would involve re-procuring the current system, and possibly including open APIs so companies could add on some innovative solutions.
In parallel they recommended a procurement for the complete redevelopment work outlined.
This would allow longer for the development and for all the patient administration system suppliers to integrate with and test the new system.
Lindberg said Intellect had not received feedback regarding where the project was at now and whether the team was still pursuing the December 2013 deadline.
The implications if the redevelopment was not successful were significant as GPs would have to revert to paper-based referrals.
“That will probably demean any future process and the reputation of IT as being able to make the NHS a more efficient effective and safe service,” Lindberg said.
Figures provided by the DH earlier this year showed overall Choose and Book usage was at 50%, ranging from 77% usage in the South West, to 26% on the South East Coast.
Intellect Health and Social Care Council member Ewan Davis commented: “It’s not necessarily much loved, but whatever you think about it, it’s now being used for a significant number of referrals.”
Davis said industry representatives told the Choose and Book team late last year that to re-platform the system by December 2013 was “not an option”.
He said suppliers across the board agreed on this. “A lot of people are not interested in providing Choose and Book, but in delivering products that could interface with it, so there was a pretty comprehensive cross-section of the industry [at the meeting].”
Davis compared Choose and Book to the software underpinning travel websites called Sabre, which was provided by IBM but with open APIs and commercial terms that were reasonable, thereby encouraging innovation.
“The functionality is not massively different to Choose and Book. People are saying that if the Cerner system works, as long as they wrap it in open API, we are happy to leave it and let it work like Sabre,” he said.
Davis said that was not the consensus view at the Intellect meeting, but a significant group thought there was no need to move off proprietary software.
“Cerner seemed positively enthusiastic about that idea and I think it’s genuine,” he added.
An NHS England spokesperson told EHI in January that it acknowledged timescales were tight to run and conclude a procurement before the current contract expired.
"Once the requirements are established we will move rapidly," the spokesperson said.
The programme for a Commissioning conference held in London in June says the new e-referrals service will be launched there on June 12.