Half of hospital appointments still made on paper
Only half of outpatient appointments made by GPs are through the flagship Choose and Book online service – costing the NHS tens of millions of pounds every year.
Introduced a decade ago – at a cost of £356m - the electronic system speeds up treatment and has even been credited with cutting costly ‘no shows’ by patients. One NHS trust, Doncaster and Bassetlaw Hospitals, reported a 60% fall in the number of missed appointments in some services, because patients had picked the time and date at their own convenience.
But half of all appointments – around 40,000 a day – are still paper-based, made either by email or even by fax, a National Audit Office (NAO) report has found. ‘Choose and Book’ is believed to save the NHS around £16m annually, but could save a further £51m if it was used for all appointments, the NAO found.
Its report says: “‘Choose and Book’ is already available to primary healthcare services (for example, GP practices), Trusts and patients online, but is not fully utilised. The main savings would arise from reductions in process and staff costs, as patients book their own appointments and are less likely to fail to attend clinics." “However, our case study evidence suggests that the full benefits of ‘Choose and Book’ will not be realised until all trusts’ services and appointment slots are made available on the system.”
The NAO did not estimate what proportion of services were unavailable on ‘Choose and Book’, having received information from 60% of 158 NHS acute trusts. The gaps are worrying for the department of health, which has made a pledge to create a ‘paperless’ NHS by 2018, updating the online service in the process.
Overall, the report warns that NHS waiting time figures cannot be relied upon, because of "inconsistencies" in the way hospital trusts measure and record data. In a sample of 650 patient files from seven NHS trusts, the NAO found 202 incomplete records and 167 instances of errors in recording when patients began and ended their wait for treatment. In 129 of these cases, the trust had reported the patient waiting for a shorter time than was actually the case. For 26 patients, trusts incorrectly said they had met the key 18-week waiting time target, when in reality they had not.
The NAO said, in light of their report, published waiting times figures for the NHS "need to be treated with a degree of caution". And it called on NHS England to introduce spot checks at hospital trusts, to ensure waiting times are being recorded and reported in the same way by them all.
Amyas Morse, the NAO’s head, said: “We have found significant errors and inconsistencies in how trusts record waiting time, masking a good deal of variation between trusts in actual waiting times. “The solution is not costly new processes, rather making sure existing processes work properly and are properly scrutinized.”