Health in the UK NHS

NHS e-Referral Service Replaces ‘Choose And Book’

Earlier this week, a report from the House of Commons Public Accounts Committee revealed that the NHS was set to replace an electronic booking system for outpatient appointments, Choose and Book.

Choose and Book was a huge leap forwards in creating a centralised appointment service and up to 40,000 patient referrals are made through the system every day, with the number of bookings exceeding 40 million since it was introduced in 2004. It has, however, come at a cost of £356m.

The decision to replace Choose and Book comes following a drop in its use by doctors and patients. Although the system was intended to speed up the appointment process and reduce on the amount of paperwork, many found the system difficult to use and time-consuming.

According to NHS England, the decision has been made to replace Choose and Book with a new booking system, the NHS e-Referral Service, with the aim of making all referrals electronic by 2018. This new system will build on the successful elements of Choose and Book but will use different technology. At this stage, the NHS has been unable to say how much this new e-Referral service will cost, although many fear this is could cost even more than the original system.

When questioned by the Public Accounts Committee about how this new system will avoid the same problems as Choose and Book, NHS England responded that there is a view to making use of the system mandatory, with an inbuilt incentive and penalty scheme to encourage doctor and hospital uptake. There were originally financial incentives for GPs to use the Choose and Book service.

The Department of Health is especially keen for patients to become more involved in managing their appointments. Between 2012 and 2013, an estimated 1.6m patients failed to turn up for first outpatient appointments, as a cost of £225m to the taxpayer.

The new e-Referral service will be launched at the end of 2014 and will allow patients and referrers to view information such as cancellation rates, waiting times and referral to treatment information. Functionality will be enhanced with a wider range of services to be booked, including diagnostics, self-referrals and follow-up appointments.

More information about the service, along with a great animation that explains the new service, can be found on the Health & Social Care Information Centre website (