NHS trusts have been criticised for failing to provide enough outpatient appointments slots on Choose and Book – and told to improve matters.

Nick Chapman, national director of Choose and Book and the Department of Health’s senior responsible officer for Choose and Book, last week sent a strongly worded letter to strategic health authority chief executives and performance directors.

In it he says that “significant numbers” of providers are restricting the publication of outpatient slots on the system and preventing patients from booking directly.

“As a result some patients are being inconvenienced and confused by a system that is supposed to enable them to book an appointment, but in practice does not.”

Instead of booking directly, patients are referred on to the Appointments Line run by NHS Direct. “The experience of patients is not what it should be and this is likely to be reflected in what patients report in survey returns,” says the letter.

In some cases trusts do not have enough appointments to offer but in many cases they have not been able to manage the day-to-day variation in referrals.

Mr Chapman says: “There is a real need to resolve these problems by improving operational management of capacity and demand at the margins and tackling any fundamental capacity problems.”

Paul Cundy, a London GP and chair of the Joint GPs IT Committee, said this was a significant issue for GPs.

“It is something that is very variable,” he told EHIPC. “Significant numbers of GPs tell me that the appointments on Choose and Book are virtual and bear no relation to the real world. In other areas it works fine.”

Dr Cundy is currently doing a duplicate referral for a patient who cannot get Choose and Book to work. “It’s complete nightmare and needs to be sorted out.”

In the same letter, trusts are also told to share their 18-week data in a move that could alter their Healthcare Commission ratings.

It says they must submit monthly “performance sharing” data for treatments that span more than one provider. This will allow breaches of the 18-week referral to treatment target to be shared between the trust that treated the patient and the trust that referred the patient. Similar data sharing has already been used in meeting cancer waits.


The letter 

New guidance on slots

This issue is one of several relating to Choose and Book that is discussed by Dr Stephen Miller, its national medical director, in the latest column from NHS Connecting for Health, published on EHI and EHI Primary Care.