Choose and Book is launching a major upgrade to its service at the end of this month.

Release 4.2 will go live on Monday 29 June and will enable GPs to find and refer patients using SNOMED terms.

The e-booking system is used for between 53% and 55% of referrals for first outpatient appointments every week, and the introduction of SNOMED terms is designed to make it easier and quicker for GPs.

Dr Stephen Miller, medical director for Choose and Book, said the software upgrade had been more than 18 months in the making.

He added: “GPs told us that they wanted to search using clinical terms, similar to those already in use in many other clinical systems, because they thought it would help patients get referred more quickly and more effectively to the right place for treatment.”

Currently GPs are able to search using ‘speciality and clinic type’, ‘named clinician’ and by key word. Release 4.2 will still enable referrers to use the specialty, clinic type and named clinician functionality, but the key word searches will be replaced by SNOMED terms.

Dr Miller told EHI Primary Care: “It will save you time if you don’t know where a service is located.

"The key word search is purely text–based, so you are relying on providers having used the exact same key words.

"If you make a spelling mistake or use a synonym you might not be able to find the service you want, whereas the SNOMED browser will make suggestions if there is a spelling mistake or come up with a synonym.”

The SNOMED browser will also enable GPs to search for services by symptom and is designed to create a level playing field under ‘free choice’, as all providers will be using the same terms.

Dr Miller said there are 32,000 services on Choose and Book of which more than 80% have so far been loaded with SNOMED terms. He said many of the remaining services were not necessarily relevant to GPs or could easily be found by referrers using the speciality and clinic type search functions.

Dr Miller added: “The providers have done an amazing job and many of them have said to us that they now feel their Directory of Services is much more accurate and reliable and helpful to referrers as a result.”

The launch of release 4.2 has been supported by an extensive training programme. Dr Miller said that at the beginning of the year, the Choose and Book team ran online training sessions for “hundreds of people” across acute and foundation trusts, private providers and PCTs to train staff responsible for defining services in the use of the SNOMEFD functionality.

A ‘train the trainers’ programme was then launched in PCTs to get staff ready to go out and train practices to use the new system, with virtually every PCT having at least one staff member trained.

However, Dr Miller said he had no information of whether the training had reached the GP practices it was designed to reach.

He told EHI Primary Care: “My greatest fear at the moment is that we don’t know how much of that training has got to the end user and that when GPs switch the system on June 29th they will wonder what has happened to Choose and Book."

NHS Connecting for Health has devised a short PowerPoint presentation to enable GPs who have not had training or want to refresh themselves on how the new system will work.

Use of Choose and Book has risen from 23,000 bookings each week day in May last year to around 30,000 bookings each week day in May 2009.

CfH said the system has also seen a 36% rise over the last 12 months in referrals to allied health professionals, diagnostics, assessment services and community based services. 100,000 referrals a month are currently made using the system.

Dr Miller said he hoped the introduction of SNOMED coding would encourage more GPs to initiate referrals on Choose and Book rather than delegating the task to administrative staff.

There is no data on where referrals are initiated, although figures show 10% of bookings are completed by GPs in the consulting room and a further 25% by administrative staff in practices.

He added: “I am hoping this will give the system another boost and those who haven’t used it before will give it a try. It takes only half a dozen clicks to shortlist services in the consulting room so patients can then ring the appointments line or book online. It takes me a minute or two at the most.”

Dr Miller said the current contract for Choose and Book runs until the end of 2011 and the team was currently working on a business case for re-procurement.

In the meantime, the team hopes for two further ‘5 series’ releases before the end of 2011. It has yet to be decided what would be included in each of those releases.


Choose and Book 4.2 training presentation