The new NHS e-referrals service has been officially launched by Beverly Bryant, NHS England’s director of strategic systems and technology.
Use of the service, which will replace Choose and Book, will not be made mandatory, Bryant told the Health+Care conference in London this morning.
However, she said she was confident that it could create a tipping point for e-referrals around the NHS.
“We don’t believe that mandating and saying things are compulsory are going to work. We need to persuade people that it’s the right thing to do,” she said.
As previously revealed by EHI, two suppliers have been shortlisted to develop the service, using open source software.
BJSS and Valtech are in the running to develop a new integration engine to replatform the product, which is currently built around functionality from Cerner Millennium. A final choice will be made in July.
Bryant said she hoped that the service would be ready in “about a year.” She also indicated that a number of front-ends could be developed, on the model of travel websites. But if patients want to receive referrals by post, they will be able to do so.
Choose and Book was developed a decade ago, after the then-Labour government promised to introduce “airline-style booking” to the NHS.
It was intended as one of a number of new, digital services to make the NHS more convenient.
However, its roll-out was significantly delayed, and usage has stalled at around 50% of referrals – although around 90% of GPs use it.
NHS England argues that the most significant problems with Choose and Book are now that not all hospital appointments are on it.
Bryant said that clinical commissioners need to work with hospitals and to use the contractual levers they have at their disposal to change the situation.
She emphasised that clinical commissioning groups could do this now, and did not have to wait for the new e-referrals service to make progress.
To demonstrate that NHS England wants to “build something that people will use”, the NHS England show stand included a list of features that the new service might include and people were asked to vote for their favourites, using coloured stickers.
A five month “listening exercise” will be run to formalise this exercise. Bryant said she not only wanted the service to make booking easier for patients, but to include better reporting tools for commissioners, to enable them to better plan services.
The Health and Social Care Information Centre has posted videos about the new service on its website.
© 2013 EHealth Media.
Make it flexiblejulianlesaux 60 weeks ago
No sooner did we start to use C&B than we started to encounter examples of services which didn't quite fit it. For example, a local GP runs a Minor Surgery service to which we make a lot of referrals. He got himself onto Choose & Book, but instead of patients booking real appointments with him, the arrangement was that they should book a "dummy" appointment and his surgery would then contact them and turn it into a "real" one. Pretty soon there were examples of this kind of bodged arrangement all over the place - including the 2 week wait system. Then the CCG started to say they didn't want appointments booked directly with providers on Choose & Book, they would prefer them to be booked with an intermediate organisation (called TACTICs in our area) which could re-route the referrals if they looked suitable for primary care provision...
I think the moral of the story is that Choose & Book was originally designed to accommodate hospital bookings, but at the same time there was a move towards patients being treated in various clinics outside of the hospital setting. It wasn't really flexible enough to adapt to the changing landscape of the NHS. Hopefully the replacement version will have a bit more flexibility built-in.
Time will tellin arduis fidelis 61 weeks ago
Having now had a chance to look at whats at the end of the web link and seeing what is on the table at the moment as proposed functionality for the "new" e-referrals system, a pause for thought.
The functionalities that are currently being outlined in the workflow examples appear to be ones that were suggested and originally intended for C&B (eg self-referrals, extended A&G, follow-ups etc) but were not introduced for various reasons not least of which were responding to detractors and the emphasis on hitting the "% op utilisation" figure of over 90% nationally. I sincerely hope that to support those of us who have championed and achieved successful engagement of C&B over the years, the functionality suggested is built in to the core system from the outset to allow the end users to decide if they want to employ them rather than having to find innovative workarounds as substitutes whilst waiting for them to be added at some undetermined point in the future when unanimous acceptance is acheived.
ExcellentPaul Cundy 62 weeks ago
This is excellent news, non mandatory, e-referring rather than diary scrutinising and interface open to all. It will be a great opportunity for core system and 3rd party GP IT system suppliers to create really user friendly functionality adn hopefully get the utilisation rate up to 90% where it really ought to be.
Non mandatory, but difficult to avoidGeepsi 61 weeks ago
Beverley Bryant, NHS England’s director of strategic systems and technology, apparently told the audience (according to another site) --
.....GPs who do not wish to use the system will still be obliged to offer the same choices as the system, meaning they would have to manually phone around hospitals for appointment to check availability in person if they opt out of the e-referral system, she confirmed......
Not new guidancein arduis fidelis 61 weeks ago
The obligation for GPs to provide choice for patients ellective referrals to consultant led services to comply with the NHS Constitution by either using C&B or by "phoning" round, has been around since Patient Choice and the NHS Constitution came in to being. Sadly due to various national teams inability to effectively make the general public aware of their constitutional right to choice the policy has been widely ignored, which is why it now appears to be a new mandate.
So whatever the system/front end/functionality there is still the larger matter of the culture change required in so many areas that have not just not engaged with C&B but primarily with Patient Choice and National policy. So whilst the system is changing for the better with changes some of us have been reccomending for years or finding work-arounds for, I wait with bated breath to see if the delivery and support will also undergo the same requisite change. Fortunately for those areas already using C&B consistently over 90% and ensuring patient choice is offered what the future holds is just learning the new elements of the new system and reaping even more benefits than they already are, for the rest there is still some serious change management required.
Well I'm excitedGinger_Geek 62 weeks ago
I'm sure many people will jump to celebrate the death (in any form) of Choose and Book, even though lack of support is it's biggest problem.
As for the new system, it looks pretty impressive. I'm sure there's a lot of stuff that has to happen behind the scenes on the IT side, but apart from that, I hope it gives people a kick to actually support and use an electronic referral and booking system correctly.
People wanted CaB to fail and in places, oh look at what happened. This time people know better and hopefully we wont see it dragged down.