Introducing Choose and Book The patient journey Presented by Date

2 The patient’s view ‘My son always takes me to the hospital because otherwise I would have to catch 3 buses and wait in the cold. I would love to be able to ask him what time suits him rather than have him alter his work shifts to suit me as this really worries me.’ Female patient aged 75, from Why Older People Want Choice

3 What is Choose and Book?  New name for Choice at Referral and the Electronic Booking Service (EBS)  Choice of convenient place, date and time for hospital appointments  By end of 2005, a choice of 4 or 5 services  Big step in giving patients greater involvement in the choices and decisions about their treatment  First major step towards an NHS where everyone is connected electronically

4 The process for the patient  Consults GP  Patient and GP decide a referral is needed  Choice of place offered – patient and GP choose using information provided by  Option to book offered  Patient either books straight away, or books later via telephone or internet

5 The administration for the patient  Reference number  Printed appointment slip  Telephone number for the call centre  Web site address  Password

6 The advantages for the patient  Research shows patients want more choice and control  Certainty of having an appointment immediately rather than waiting for a letter  Choice of a place, date and time that suits them, fitting in with childcare, carers, work and other responsibilities  Minimises need for follow up visits to GP to check referral status  Easy to change appointments  Shorter referral process

7 What influences patients’ choice?  Waiting times  Convenience  Patient experience  Clinical quality  Answers available via

8 The patient speaks ‘Well, I was sent to the receptionist and I watched her make the appointment and it was done immediately – it was very quick.’ Patient, electronic booking pilot at GP practice South London

9 The process for the GP  GP and patient decide a referral is needed  Opens Choose and Book software, accesses referral guidance and booking guidelines  Discusses preferences with patient and agrees a service  Patient chooses convenient date and time, GP or practice staff to book appointment on their behalf  Enables patient to leave practice with appointment at chosen service or to book it later  GP uses referral template or dictates referral for later

10 The advantages for the GP  Fewer queries from patients chasing referrals  Full directory of all the secondary care services available  Decision support information for referral  Advice and guidance facility  Simple referral process

11 The GP speaks ‘I would say to anyone having to cope already with a lot of paperwork, that this is not going to add to it, it’s going to make your life simpler.’ General Practitioner, electronic booking pilot South London

12 The process for admin staff  Patient shows reference number  Practice staff book the appointment  Practice staff can complete referral letter and add it to the booking  Receiving staff view referral with key information included and appointment already booked  Receiving staff print out referral letter for consultant to review  Receiving staff act on consultant’s behalf to accept, amend or reject the referral

13 The advantages for admin staff  Able to give the patient an appointment straight away so more involved in the care process  Simplifies administration  Fewer patients making repeat appointments to find out progress of referral  No lost referral letters  Immediate information about progress of referral

14 The outpatients manager speaks ‘They know exactly when their appointment is, they know why they’ve been referred, and another thing, of course, is they do turn up.’ Outpatients General Manager, electronic booking pilot at Royal Bournemouth and Christchurch Hospitals NHS Trust

15 The process for consultants  Consultants can provide advice and guidance before the referral is made  Consultants can reject referral if felt inappropriate and direct back to the GP  Consultants can change the priority of the referral and have the appointment rebooked

16 The advantages for consultants  Legible referrals using standardised referral template  Advice and guidance facility may reduce face to face outpatient appointments  Booking guidance should help ensure appropriate referrals  Fewer DNAs  More secure referral audit trail

17 The consultant speaks ‘It’s a fantastic system. It makes it much better from the patient’s point of view, because they get seen when they want to be seen.’ Consultant Surgeon, electronic booking pilot at Royal Bournemouth and Christchurch Hospitals NHS Trust

18 How will it happen? Delivery structure:  Five Clusters  National Application Service Provider Atos Origin  Local Service Providers  National and Cluster level support

19 Readiness to go-live:  System readiness  Infrastructure readiness  Stakeholder engagement and cultural change  Process Redesign and Training  Extent of electronic booking in the community  Other booking  Choice  Booking Management Service  Change management

20 What may come next?  Patients booking via the internet into primary care  Services delivered via Digital TV  Linked appointments  Transport requirements  Primary-to-primary booking  Tertiary booking and referral  Follow-up appointments  Clinical assessment services  Onward referrals

21 Choose and book - the future of care ‘Having a choice of appointments, and making it quicker as well, means you don’t have to wait so long – because if you’re feeling anxious it’s not so good to have to wait a long time. ’ Patient, electronic booking pilot at Royal Bournemouth and Christchurch Hospitals NHS Trust

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