Clinical Informatics

Choose and Book: A critical appraisal of its early development


  1. Introduction and definition of “Booking”

  2. Historical context

  3. Aims and Contents of the Choose and Book project

  4. Key findings of the National Audit Office report: Patient Choice at the Point of GP Referral, Jan 2005

  5. The strength and weakness of the original proposal

  6. Overall appraisal of the project

  7. References

Overall Appraisal

The best summary of the project can be found in the combined statement of the British Medical Association and the Royal College of GP.

The principles and benefits of offering Choice to the patient are good. However, there are scepticism about its implementation and dissatisfaction among the clinicians with the almost non-existence level of consultation in development of the project and low levels of clinical engagement.

There appears to be a conscious change in the agenda of the initial electronic booking project to one that puts Choice above all else.

This is despite the fact that the majority of studies involving patients and clinician do not put choice at the top of their priorities. Instead, patients and doctors in UK prefer to have good services that are available locally, for convenience and also to facilitate visiting by family and friends.

The recent roll-out of EMIS Access system in 2005 that enables patient to book GP appointments 24 hours a day through the Internet shows how powerful and useful a well-designed booking system can be.

The focus on choice has added such complexity to the booking service that makes its provision very difficult in the real world, thereby leading to unnecessary delay and complications in the implementation of electronic booking and all its benefits to patient care.

The NAO report has also shown that it would not be possible to provide patients with the kind of detailed and relevant information at present in order to allow informed choice.

Therefore, Choice should not be made the main priority of the project in order to allow the realisation of other achievable targets which matters more to patients and General Practitioners.

[This review was completed in 2005, based on the developments and literature available for the Choose and Book project at that point in time]


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Page Updated: 17 May, 2017

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