Nicholson says C+B use not based on payments

NHS chief executive David Nicholson last night said that use of Choose and Book remains disappointingly low but has become a fact of life in the NHS.

Answering MPs’ questions about Choose and Book use at the House of Commons Public Accounts Committee hearing on the NHS IT programme, Nicholson said: “Utilisation of the system is not as great as we would have imagined at this stage.”

Originally the DH anticipated 39m appointments via Choose and Book by 2008, the actual figure is closer to 6m. A number of targets have been missed, including for 90% of referrals for first outpatient appointments to be made through Choose and Book by March 2007.

But the NHS chief executive robustly defended the system, saying “On average half of first appointments are now made through the system.”

Fears the ending of financial incentives to GPs to use the system would lead to a decline in its use were unfounded, he added.  “We stopped payments to GPs and utilisation has still gone up so that’s not a factor.”

He said that to help boost use of the system, the DH would try to build patient demand for the system: “One of the things we will do as part of the next stage review is to publicise patient’s rights to choice, to get pull.”

Dr John Pugh, MP, said that one reason why Choose and Book had worked was because it didn’t remove GP choice of system; “One thing about Choose and Book was that GPs could use their own systems.”

Connecting for Health’s Dr Gillian Braunold added that although she experienced frustrations with using the system sometimes, she now found it invaluable. “My vulnerable patients now leave the consultation room with an appointment for their hospital consultation.”