Health minister Ben Bradshaw has told MPs that local implementation issues are at the root of most complaints about Choose and Book.
Bradshaw told a House of Commons debate about the electronic booking system that useage was growing, with 57% of bookings made through Choose and Book in January and more than 30,000 bookings made in a single day for the first time last week.
He told MPs: “I acknowledge that sometimes the system has been slow and that occasionally there have been problems with system availability, but virtually all the problems that honorary members have raised today are problems not with the national Choose and Book system but with how individual primary care trusts, hospitals and GPs implemented it or engaged with it.”
The debate was secured by Andrew Stunell MP, who said he faced a steady stream of constituents who found the Choose and Book system too complicated to use, with long delays in getting appointments.
Cases included a patient who was given a Choose and Book telephone number to call in July 2007 but could not get through on the appointments line and eventually ended up having his treatment in January 2009.
He said: “Nearly all patients and every GP knows where treatment should be provided and often by which particular consultant. Instead, they get offered a so-called choice which often doesn’t even include the option that would suit them best.
“They are the lucky ones. Government figures confirm what my constituents tell me. One in sixteen calls to Choose and Book don’t get answered at all, and callers who get through often get given a standard message to say there are no appointments available.”
Bradshaw said the performance of the national appointments line was “generally good” and GPs needed to “take the time to get to grips with the system.” He said PCTs also needed to set up their IT systems to make the most of Choose and Book. He said some PCTs were using Choose and Book for 95% of referrals while others used it for less than 30%.
He added: “Some PCTs do not train their staff, including their GPs, in how to make the best use of the system. Some do not agree with their local providers how services should be displayed.
“And some do not use the clear provisions in their contracts with providers to enable referrals to flow freely through Choose and Book. We are pressing PCTs to work closely with their GPs and providers to resolve these issues.”
Mark Hunter MP said he felt PCTs would be “astounded” to hear the minister’s views. “If the minister would term the system a great success I sincerely hope for all our sakes that we never find out what he would consider to be a failure.”
Stunell asked the minister what he intended to do about the “black hole” that was created because appointments over 18 weeks were not available and about lack of slot availability.
Bradshaw said it was “totally unacceptable” for patients to not be allowed to wait to see the consultant of their choice because of the 18 week target.
He added: “Patients should be able to wait longer than 18 weeks if they want to do so but we must not let hospitals off the hook about bringing down waiting times, which all patients appreciate.”
He told MPs that the DH was looking into the study published this week that showed DNA rates were higher under Choose and Book. He said: “All the other evidence suggests that Choose and Book significantly reduces did-not-attends.”