NHS system slammed

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The multi-billion pound national Government 'Choose and Book' initiative was introduced in East Sussex to allow patients to choose from four health service providers on a computer in their doctor's surgery and book there and then.

But figures from the South East Coast Strategic Health Authority (SHA) on Choose and Book show that progress has been way short of expectation.

This year, only 41 referrals were made between April and August inclusive in the Bexhill and Rother PCT area '“ just four per cent of the target 1,027.

In the Eastbourne Downs PCT area 358 of a target of 2,316 (15.4%) referrals were made and in the Sussex Downs and Weald PCT area, the figure was 306 of a target 2,924 (10.5%).

Only in the Hastings and St Leonards PCT area, where 568 of a target 1,148 (49.5%) referrals were made, did bookings reach anywhere near half of the target.

Terri Agnew, Choose and Book Programme Manager East Sussex Area, admitted at a meeting of East Sussex County Council's Health Overview and Scrutiny Committee that take-up had been slow.

She blamed lack of progress partly on the fact that important data had yet to be uploaded to the system but added that she hoped for a surge in usage by the end of September when this work had been completed.

After the meeting, Committee Chairman Cllr Bob Lacey said: "The Government and the NHS have claimed this system will revolutionise current booking arrangements but the performance in East Sussex, at least, has been particularly disappointing. Choose and Book is overdue, over-budget and under-used.

"If this continues, a huge amount of public money will have been wasted on a system that is not improving healthcare in the county."

The committee recorded that the faltering IT system should have been in place before the new system came into use. Members also said that the system has not been 'sold' effectively to GPs, many of whom are not using it.

They asked for the financial implications for the slow take-up to be assessed and demanded another progress report be presented at their November meeting.

Notes to editors

Issues arising

The data received points toward a substantial underperformance against targets in East Sussex.

Nationally, the number of referrals going through Choose and Book is increasing and the average stands currently at 21%. The South East Coast SHA (new and old) is achieving 12%. East Sussex is scoring approximately 5% against a planned 35%. Within Surrey and Sussex, East Sussex is the worst performing area.

The South East Coast SHA suggests the following possible explanations:

Acute trust impact

East Sussex has a lot of problems with implementation but many are not technical in nature. East Sussex Hospitals NHS Trust has been very slow in publishing all its services. It could be that the Trust is still not fully live, and it appears to be 'drip feeding' Choose and Book. This means the slots offered are quickly booked leaving patients with no choice of date or time.

The SHA suggests that this situation allows GPs to state that until the situation changes, they will not use the system.

In other areas (Crawley, North Surrey, Surrey Heath and Woking), PCTs are already exceeding 20% showing that quick gains can be made when all parties are supporting the project.

Technical issues

All GPs were technically compliant by the end of December 2005 for the web based version of choose and book. The GP Clinical Computing System version has been very slow to deploy and pressure has not been exerted '“ as with other areas '“ for the GPs to use the web based system and not wait for the GP Compliant version. (The web based referral system allows a GP to access Choose and Book via a standard web browser until their Clinical Computing system can be successfully upgraded.)

Re-organisation impact

The PCT re-organisation has meant the PCT staff minds have been on other priorities and may have not embraced this project as enthusiastically as has occurred in other areas. GPs in East Sussex comparatively have been very reluctant to engage.

The Health Overview and Scrutiny Committee met on September 22.

For more information on HOSC see the website at http://www.eastsussexhealth.org/

For further information please contact: Mike Taggart, Communications Manager '“ Adult Social Care:

Tel: 01273 481435

Email [email protected]

Note on HOSC:

The Health Overview and Scrutiny Committee was set up in October 2003, by East Sussex County Council in response to Government aims to get people more involved in health decision-making and improving local health services. The committee includes the local districts and boroughs '“ Eastbourne, Hastings, Lewes, Rother and Wealden '“ and representatives from the voluntary sector.