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Open Access Highly Accessed Research article

Does Choose & Book fail to deliver the expected choice to patients? A survey of patients' experience of outpatient appointment booking

Judith Green, Zoe McDowall and Henry WW Potts*

BMC Medical Informatics and Decision Making 2008, 8:36  doi:10.1186/1472-6947-8-36

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Response to Connecting for Health's press briefings

Henry Potts   (2008-08-11 13:16)  University College London email

In responding to press interest in this article, the Connecting for Health press office have argued that the situation with Choose and Book has moved on significantly since we collected data in 2006. In making that case, they have drawn heavily on the January 2008 National Patient Choice Survey of 72,000 patients, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_085329 . In this, patients were asked whether they were given a choice of hospital for their first outpatient appointment. The January 2008 survey found that only 46% said yes (38% for their Hillingdon sample). There has been a consistent figure of between 40-50% nationally from the November 2006 survey onwards, and similar results were found in the National Patient Survey on primary care services in early 2008, http://tinyurl.com/6oacsa .

In our study, we specifically identified patients who had been through Choose and Book (finding 68% reported having had a choice of hospital), whereas the national survey figures (40-50% report having had a choice of hospital) are for all patients, of whom only about half have been through Choose and Book. Thus, it is difficult to make a comparison. Unlike our study, the National Patient Choice Survey did not ask patients whether they had a choice of date and time for their appointment, nor did it ask whether patients had a choice from at least four hospitals.

The National Patient Choice Survey figures show that most patients are still not experiencing a choice of hospital. Moreover, there is no clear evidence from the January 2008 survey of any improvement on the results we found. We found a comparable proportion of all patients saying they had a choice of hospital (41% versus 46% in the 2008 national survey; not statistically significant) with the worst results for Choose and Book in our study coming from questions that the National Patient Choice Survey do not ask.

Connecting for Health’s insistence that the situation has improved is not supported by their own data. The proportion of patients experiencing a choice of hospitals is little changed over the last two years and they have not specifically asked Choose and Book patients about choice of time or date. Numbers using Choose and Book have been increasing, but if those going through Choose and Book are not experiencing the expected choice, more people going through the system is not going to improve the situation.

Dr Henry W W Potts

Competing interests

Co-author of original paper

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