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Realising the Benefits

More efficient referral system, greater certainty for patients, improving patient experience

Choose and Book is not just a technical process. It is about Primary and Secondary care service redesign to improve the patient experience.  The main challenges and benefits come from incorporating the technical tools with the clinical and business processes to ensure that all patients are offered clinically appropriate choices.

Choose and Book creates benefits throughout the referral process for patients and the NHS. It results in a better patient experience due to greater certainty of appointment, and a better experience throughout the NHS.  A more efficient referral system eliminates much of the paperwork and time lag of the previous system.

As well as transforming the patient experience of the NHS, clinicians and NHS staff will also see real benefits.

2014 Patient Survey

A Patient Survey was conducted in January and February 2014.

The survey aims were:
1. Obtain Choose and Book benefits evidence for patients
2. Compare patient experiences between being referred via Choose and Book or via paper/manual
3. Identify choice offering to patients via Choose and Book e.g. choice of provider/appointment
4. Compare 2014 survey results with previous surveys

The 2014 survey received 2024 fully completed responses.  The full survey and results are available in the 2014 Choose and Book Patient Survey Results Final document (PDF, 269Kb).

The Outpatient Pathway Modelling Tool

The Outpatient Pathway Modelling Tool compares service provider's current referral management processes with a best practice model. It can be used to calculate where greater benefit could be achieved by identifying areas where time and cost efficiencies could be made through the referral process. Find out more and access the model.

Primary care clinicians (GPs and GDPs) and their practice staff

  • Referrers have a full directory of all the secondary care services available under Free Choice via the Directory of Services as well as those services locally commissioned by their PCTs.
  • Referrers and practice staff can direct the patient to use the Choose and Book Appointments Line or the internet where they are unable to complete the booking themselves.
  • Flexibility in the Choose and Book service means the referral process can be adapted to suit different working conditions.
  • Referrers can identify services with shortest waiting times through service selection.
  • Referrers can access service specific guidance to help them to shortlist the most appropriate services and to highlight any helpful preliminary investigations.
  • Referrers are able to seek advice and guidance from specialists prior to referral, supporting the development of better referral pathways and closer collaboration with secondary care colleagues.
  • Referrers and practice staff can track the progress of a patients referral through Choose and Book.
  • Referrers and their practice staff have much greater access to their patients' care management plans, ensuring that the correct appointments are made.
  • Referrers and practice staff see a reduction in the amount of time spent on the paper chase and bureaucracy associated with existing referral processes.

Secondary care consultants and booking staff

  • Consultants have the opportunity, through the use of Advice and Guidance, of a dialogue with referrers to ensure patients are booked into the most appropriate clinic.
  • Consultants have the opportunity to provide clinic specific details to referrers (in the Directory of Service) before referral, enabling better quality referral information.
  • Consultants are able to access the referral information through Choose and Book and action it accordingly.
  • Consultants will see a reduction in the number of patient Did Not Attends (DNAs) who don't turn up for appointments because patient's agree the place, date and time of their appointment.
  • Consultants receive fewer inappropriate referrals because clinics are carefully defined and referrers can seek advice prior to referral if there is any doubt about which clinic to refer to.
  • Consultants have a secure audit trail.
  • Consultants and booking staff will see a reduction in the administrative burden of chasing hospital appointments on behalf of patients.
  • Consultants can review and process referrals securely on line, removing the need for paper referrals and their inherent risks.

More detailed benefits relating to clinical governance and patient experience are:

Increased provision of services which are convenient to patients

The journey through the NHS is increasingly patient focused.  Appointments and admissions are made in discussion with the patient to get a mutually suitable date and time.

This is an immediate benefit to patients.

Reduced Anxiety

Waiting to hear about appointments is a key concern for all patients.  The electronic booking of appointments provides patients with more certainty. This helps them make arrangements and plan for the appointment. The key benefit is not having to wait weeks to receive a letter which tells the patient when their appointment will be.

This is an immediate benefit to patients.

Increased Referral Security

Confidence that the referral information reaches the hospital and that the information contained is protected by a series of stringent access controls and information governance.  There is the ability to link and update referrals with up to date clinical developments.

This is an immediate benefit from day 1.

Reduction in DNAs

Data from previous electronic booking pilots show that when patients are given a choice of date and time for their appointments they are more likely to attend.  This leads to fewer wasted appointments and helps to improve the overall efficiency of outpatient clinics.

This is an immediate and ongoing benefit.  Case Study - Doncaster and Bassetlaw Hospitals NSH Foundation Trust Reduce DNAs by 60% PDF 80.6kB

Reduction in non clinical primary care consultations

The amount of time spent by administrative support staff in responding to patients' enquiries about the progress of referrals is huge.  In some cases a patient will book an appointment with their referrer specifically to enquire about their referral.  This reduces the amount of clinical time available in a practice.  Eliminating this administrative burden brings an immediate benefit in primary care for patients, referrers and practice staff.

This is an immediate benefit.

Reliable and comprehensive clinical information

Referral information from primary care systems will be made available to hospital clinicians in a legible and consistent format.  Development of the National Care Record service will allow relevant patient information supplied by referrer and hospital systems to be accessed by authorised users wherever and whenever it is needed.

This is an immediate benefit which will increase in time as the National Care Record service becomes more widely available.