Thursday, 23 September 2010

Choose and Book – get some more!

Earlier in the year we posted a piece of about one of the teams family’s experience of using Choose and Book.

We thought we would update you as to how well Choose and Book is serving its users. When we left we were still waiting to get an appointment with one speciality but had booked another appointment via Choose and Book at a date and a time of our Choice only to have the hospital rearrange (C&B) it for us.

A few days after the post we went on line and instead of the usual message we had seen for the past 4 and a bit weeks:

There are currently no appointments available please try again later. Please call the C&B Appointment Line on 0845 6066 8888 for further information.

This was the sight of an oasis in the desert of appointments for this speciality - 4 whole appointments. This was early in the morning before work and so the person who needed the appointment was roused from their bed, before reveille, and with much protestation and was asked “which one do you want?” for we know that when these appointments appear they disappear like snow in the Sahara at midday.

A rapid consultation of 2 peoples’ work schedules followed and 2 of these appointments were at the right hospital and at a convenient time and so one was booked and the details printed off.

At last we had been given a Choice and were able to Book it. Job done but now the real wait began.

Remember what the Party propaganda says:

Choose and Book is a service that lets you choose your hospital or clinic and book your first appointment.”

But not your consultant . . .

. . . fit your treatment in with your other commitments and work . . . choose your appointment that fit your carer’s schedule . . .”

but only after several weeks wait and from a choice of only 4 slots only 2 of which were at the right hospital so clearly the promise of being able to book in the doctor’s surgery with the doctor then and there was honoured.

Now if you are dealing with children, the elderly or dependant patients the ability to choose a time is important. We usually reckon that if you have a hospital out patient appointment it means losing half a days work which as a GP would mean cancelling a full surgery, possibly not doing visits and possibly another clinic or minor operating session.

We here at ND Central try to get appointments on half days off or do an extra surgery to make up for an appointment but we can be flexible. A lot of employed people do not have such flexibility or understanding from their employers. If you are an employee with a child or an elderly relative this can mean that hospital appointments, especially if recurring, be a real nightmare.

So having a fixed appointment means you can plan ahead which we did.

A week later we received a letter saying we needed to ring the hospital in order to book an appointment which we thought we had already done and being technocrats we had done it the sleek modern way online. How smug are we!

So we rang the number on the letter and this is the conversation that followed:

“Comrade patient I am Comrade Senior Appointment Clerk Commissar Olga Bollocovic how can I help you?”

We have had a letter saying we need to ring to make an appointment but we already have one we booked online.

“That is because comrade patient you cancelled it the computer says you did so 3.473 days after you made it.”

“No we did not!”

“Oh we meant the consultant read your comrade doctor’s referral letter and decided that you had booked the wrong clinic so you now have to make a new appointment . . .”

So after over a month of waiting, booking an appointment online, with only a choice of times and places not clinic types, we are told we had cancelled the appointment and now had to make another one which we did.

If this situation happens where a patient books a clinic but when the consultant finally sees the referral letter decides it is the wrong clinic we are told it should be the hospital’s job to rebook the appointment.

This happens all the time as many patients do not know what clinic they need so if for example they have a cataract they will book an "eye surgeon" appointment which may mean they land up in a squint clinic for children such is the sophistication of the C&B software and the fact that the consultants no longer allocate the appointments after reading a referral letter.

The new improved computer interface allows the patient, who may not know what is wrong with them, or what clinic they need to book the appointment before the referral letter has even been done. Choose and Book software is all knowing and all powerful and can sort all of this out.

We then had to reschedule surgeries school runs as a result.

We counted up how much effort we had put in to get 2 hospital appointments. We have a total of 9 pages of A4 paper sent out from hospitals to make/cancel/rearrange 2 appointments. We have had to make several phone calls to confirm/ rearrange appointments as well as confirm our intended attendance. We have had to go online every day for over a month to try and get an appointment – you could, if you wish, ring up every day to be told there are none.

Not bad eh? Clearly an improvement over the send one letter get one appointment back usually for the right clinic.

Praise to the Party for whom Progress means taking one step into the electronic age and in doing so going 15 steps further back into the Stone Age. The worst bit about it is that those who trained us and mandated Choose and Book use said it would be a paperless, one stop exercise.

Did we miss something? And remember this is being repeated all over the country many, many times each day. Efficiency saving, sorry, gain anyone?


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Muhammad Shoaib said...

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