What is Choose and Book?

Choose and Book is a service that helps the patient choose their hospital, clinic or service and book their first appointment.

When the patient and GP agree an appointment is needed, the patient can choose which hospital, clinic or service they go to. The patient will also be presented with choices about the date and time of their appointment.

How does Choose and Book support Allied Health Professionals?

Choose and Book allows GPs to find the appropriate services for their patients using clinically relevant search terms, derived from SNOMED Clinical Terms. This helps the referrer to find the right service for the patient, in the right place for their first appointment.

Choose and Book has supported Allied Health Professional services such as physiotherapy, podiatry, nutrition and dietetics nationally since 2008.

New specialties including speech and language therapy, occupational therapy, orthotics and prosthetics were added early in 2010. 

What Allied Health Professional services are included in Choose and Book?

The majority of Allied Health Professional services are live on Choose and Book.

Physiotherapy, podiatry and dietetics have been live since early 2008. Speech and language therapy, occupational therapy, orthotics and prosthetics were added in March 2010. GPs can now refer directly into all of these Allied Health Professional specialties where they are commissioned by the NHS.

The Directory of Services has been updated to include a wider range of SNOMED clinical terms (clinically relevant search terms), to support easier access to the Allied Health Professional specialties.

How would a radiography service be included and find their services in Choose and Book?

NHS radiography services can be listed under the existing diagnostics specialty in Choose and Book. This is already happening in some areas.

A provider wishing to list radiography services on Choose and Book will need to define and publish these services in the secondary care menu of the Directory of Services.

What is the Directory of Services (DoS)?

The DoS is the core of the Choose and Book application:
• It holds information that describes the services that organisations offer.
• It enables referring clinicians to search for appropriate services to which they can refer patients.
• It provides a window through which providers can display their services.

Service providers publish their services on the DoS in Choose and Book. This enables referrers to see a list of appropriate services when referring their patients. In the case of local services, commissioners need to specifically identify (commission) which services they wish to appear on the ‘primary care’ (available locally to GPs) menu, and which will appear on the ‘search all’ (national) menu.

Service descriptions for publishing on Choose and Book are written by service definers, using the service definition tool. This should be the clinician working with the Choose and Book lead in their organisation. The services are categorised by specialty and then broken down into clinic types. A spreadsheet containing all current specialties and their associated clinic types is maintained on the Choose and Book website at the following link:
http://www.chooseandbook.nhs.uk/staff/gettingmore/dosoptimize/sct.xls

Can Allied Health Professionals put any or all of their services into the Directory of Services?

The Choose and Book system is currently focused on referrals from primary care (e.g. GPs) and any NHS commissioned service can be published. Services provided by secondary, primary or social care can be listed and may offer a variety of styles of service; triage, home visit, telephone or clinic appointment. For further information on the Directory of Services and how best to enable your Allied Health Professional service to go live, contact your local commissioners or Choose and Book service definers.

Can Choose and Book manage referrals for the same or next day?

Local processes do not usually allow for referrals to happen this quickly. Three days is the usual minimum turnaround time that providers use. A telephone contact can be provided to enable the referrer to action a referral more quickly.

Can Allied Health Professional services be offered through Choose and Book if appointments are not managed through a compatible Patient Administration System (PAS)?

Allied Health Professional services are listed in the Directory of Services so they are visible to referrers, but appointments would need to be booked through the Indirectly Booking Service (IBS) route. This means that the patient will be provided with information about the service and how they can contact the service provider directly to organise their appointment by the referrer.

What happens if there is no appointment available?

All service providers are responsible for ensuring that they have enough capacity to meet demand, and this includes having sufficient appointments available.

For Directly Bookable Services (DBS) – if a referrer or TAL tries to book an appointment with a specific provider, but no appointments are available, they are able to use the 'defer to provider' function to inform the relevant provider. The provider then has a responsibility to ensure that the patient is contacted, kept informed and given an appropriate appointment. Patients are also able to forward their details to their chosen provider via the patient web application

For Indirectly Bookable Services (IBS), - which is when service provider does not have a compatible scheduling system - the service provider should always be able to book an appointment with the patient.

What is The Appointments Line (TAL)?

The Appointment Line provides a telephone booking service for patients to book, amend and re-book first outpatient appointments via Choose and Book. The Appointments Line is open to all patients seven days a week.

What is a Clinical Assessment Service (CAS)?

A Clinical Assessment Service provides the functionality to clinically triage a referral before deciding on an appropriate service to refer the patient on to. This can be a paper based triage or a face-to-face assessment. Patients can be treated at this assessment or, where a more appropriate service is identified, the patient can be referred on within Choose and Book, without a need to raise a new referral.

Can Allied Health Professionals raise referrals, for example from a Clinical Assessment Service (CAS)?

Within a Clinical Assessment Service, Allied Health Professionals can only forward on referrals that are received.

Is it worth setting up a Clinical Assessment Service (CAS)/triage service?

If a high volume of patients need to be assessed in order to determine the most appropriate service, it is worth setting up a CAS.

A CAS is quite often used for local physiotherapy services, or for general orthopaedic services when the local community have agreed that the CAS clinicians can see and act appropriately on each referral. Some areas have decided that the CAS is an unnecessary structure, therefore before setting one up it is recommended that guidance is taken from the Choose and Book lead in the organisation.

If a service is run from multiple locations does it have to be loaded into the Directory of Services as a clinic for each location?

The service information should be loaded as a clinic for each location. This ensures all the information about the clinic is correct and up-to-date. The location of a service is a key element in the choice discussion with the patient.

Can private Allied Health Professional providers list their services on Choose and Book?

Yes. Any organisation commissioned to deliver NHS services can be published in the Directory of Services.

How are services provided by social services, integrated social care and health trusts accessible through Choose and Book?

NHS commissioned social services, integrated social care and health trusts services can be listed in the Directory of Services within a provider organisation. If the provider does not have an integrated Patient Administration System (PAS) they can set up an Indirectly Bookable Service (IBS).

Is there a minimum lead time for appointments to be made available on the Choose and Book system?

The minimum lead time for appointments (the time to the first available appointment) is specified by each service provider. To allow for administrative processing time, this is set locally and does vary between service providers, speciality and clinics.

Is there an expiry date for a referral if it is not actioned?

There is no expiry date on a referral, however, it is expected that referrers should monitor their worklists to follow up any patient who has not booked their appointment in a reasonable time. Every patient will get up to two reminder letters for an unbooked appointment.

How much time does it take to redirect or reject inappropriate referrals once they have been received?

If the Directory of Services is set up correctly, inappropriate referrals should not happen. Provider clinicians checking their worklists can review incoming referrals and immediately reject or redirect referrals onward to a more appropriate clinician or service if necessary.

Does using Choose and Book reduce ‘Did Not Attends’ (DNAs)?

There is evidence of a reduction of 30-70% in DNAs when patients have been able to choose their own date and time.

There is however some evidence of increased DNAs when local areas do not enable patients to participate in choosing their date and time.

How does the Choose and Book service work for patients with additional needs such as language support or advocacy?

Choose and Book does not offer a substitute for the relationship between the GP and patient. The responsibility remains with the GP to ensure each patient is able to be referred, and to highlight on the referral letter and within Choose and Book if there are additional needs such as language support, advocacy or other requirements.

There is formal guidance for clinicians supporting all patients on the Choose and Book website at:
www.chooseandbook.nhs.uk/staff/communications/fact/access.pdf

How can the referrer find appropriate services for children or older people?

When a referrer searches for a service they can:

Is there a facility to seek advice on how appropriate a referral is before the booking is made?

Yes. The ‘Advice and Guidance’ function for referrers can be used to check whether a referral is appropriate and which service would be the right option. Additionally it can be used to seek advice on medication or other non-referral options.

Under the Free Choice agenda can Allied Health Professionals elect to limit access to their services?

If a service is listed on the ‘Search All’ (national) menu, Free Choice applies –  the patient can be offered the service. This does not apply to services listed on the ’Primary Care’ (local) menu which have agreed funding within the local community.

How can information about a service in NHS Choices support patient choice in Choose and Book?

A patient can compare specific options on NHS Choices if they have been given a letter from their GP with a booking number and a password. The patient is then able to book their appointment online using Choose and Book.

Who is responsible for the information about a service in NHS Choices?

Provider organisations have access to an NHS Choices tool which allows them to manage and edit the information in their profile on NHS Choices. This also includes the ability to create specific pages for each department or service.

Are there any language options for the referral information provided to the patient?

The responsibility remains with the GP to ensure each patient is able to be referred, and to highlight on the referral letter and within Choose and Book if there are additional needs such as language support or other requirements. There is formal guidance for clinicians supporting all patients on the Choose and Book website at:
www.chooseandbook.nhs.uk/staff/communications/fact/access.pdf

The appointment reminder letters are available in a number of languages and also large print and braille are available if the referrer has identified this need.

What are Directly Bookable Services?

This is where a service provider's appointment system is directly linked to Choose and Book so that appointments can be booked at the GP practice, online by the patient, or by The Appointments Line (TAL). The GP or practice support staff should discuss the options with the patient.

What are Indirectly Bookable Services?

This is where a service provider's appointment system is not directly linked to Choose and Book. Patients are required to contact their chosen hospital or service directly to arrange their appointment but do not have the other options of The Appointment Line or the internet to arrange their appointment.

If the appointment is for an IBS service, this is clearly highlighted on the ‘appointment request letter’ and should be explained by the GP to the patient.

Is Direct Booking the best model?

In most cases yes, but sometimes Indirectly Bookable Services (IBS) offer the opportunity for the provider to assess a patient's clinical needs and arrange additional tests prior to the appointment (e.g. scans).

What does the ‘Indicative Waiting Time’ (IWT) mean?

This is an indication of how long the patient may have to wait before being seen. The information is valid at the time the referral is made.

For Indirectly Bookable Services (IBS) the value is the average wait of the last 20 appointments. For Directly Bookable Services (DBS) this will be the time to the third available appointment.

Can a patient cancel their original appointment and book in with another provider through Choose and Book?

The patient can cancel and rebook an alternative date and/or time with the same provider using the Patient Web Application (PWA) at home, or by calling The Appointments Line.

If the patient wants to use another provider and the options are on their shortlist, then they need to contact The Appointments Line.

Is there a Choose and Book network to enable users to share learning?

There are ten Strategic Health Authority (SHA) user groups. These are run across the country, at trusts and at SHAs sharing information and user experiences. Each SHA has its own AHP lead.

How can we learn more about the Choose and Book system and processes?

Every provider has a Choose and Book lead and a local Choose and Book trainer who are experts on the system use, training, delivery and implementation. These leads can raise queries at national forums and disseminate information to users.

For more information go to: www.chooseandbook.nhs.uk/staff