Two years and 196 million pounds later: where is Choose and Book?

Introduced in 2004, Choose and Book was one of the National Programme for Information Technology's vanguard initiatives. It was to transform the old booking system by combining, for the first time, electronic booking with patient choice of their first hospital appointment. However, doctors' use of the system has been reported as being persistently low. This study, carried out in London, endeavoured to explore doctor's views about the system and to see how far it has progressed.

A questionnaire was devised and administered via an email invitation, to doctors. It was sent to 1800 and completed by 105 hospital consultants and general practitioners.

Most doctors thought that the concept of electronic booking itself was a good idea. The benefits that have been observed so far include an improvement in patient attendance at their appointments and the ability of doctors to track referrals. The biggest problems were described as an increased workload, technical problems and an uneven distribution of appointments between hospitals. In addition, most doctors thought that patient choice was a misguided concept in electronic booking and most reported that they were unsatisfied with Choose and Book overall.

The 6% response rate may make the results less likely to be representative of the whole survey population. The authors acknowledge this and have made recommendations as to how to more comprehensively test the objectives of this study, in future.

In general, Choose and Book is still poorly perceived by doctors - particularly with respect to technical problems. There is still some support for the concept of electronic booking; however the patient choice element faces more resistance. Additional research is needed on this topic to further investigate the use of electronic systems in the health service.