Do not think of Choose and Book as just another technology project.

Moving to the system is challenging and there is far more involved in it than, for example, upgrading your desktop software.

The most important first step, in my view, is appointing one person to lead the implementation. Often the most appropriate person is the practice manager. He or she can co-ordinate the different stages, ensure the right people are involved at the right time and liaise with the PCT.

Close teamwork

The practice implementation lead works closely with the PCT's Choose and Book project manager and local IT teams and plans what needs to happen, when and by whom. However, the whole practice team does need to be involved, to a greater or lesser degree, from the outset.

It is essential to consider patient experience when you plan the move from traditional referrals to electronic bookings. Patients will not be used to choosing services so it is important that information is available on locally commissioned services. Booklets are available from PCTs and various websites such as www.nhs.uk.

It is advisable to study different options for making referral bookings (see GP, 9 June and 16 June). Flexibility is built into the Choose and Book service so that practices can tailor the referral process to suit local circumstances. I also recommend asking other practices already using the system what they found worked well and what they felt they could have done better.

Enhanced services

The practice team needs to understand the minimum requirements to qualify for the choice and booking directed enhanced service payments (DES). These are that the patient leaves the surgery with either a booked appointment or armed with information on how to make a booking after choosing a provider.

The latter entails giving the patient an appointment request and a password - both automatically generated by the booking software.

Beware of underestimating the need for adequate training. Some practices nominate a team member to be a 'super trainer' who does internal and ad hoc training to supplement any formal training. GPs may go two or three days without making referrals so it is useful to have someone available to provide top-up help.

The practical details need to be fully thought through. For example, you may be printing appointment requests for patients during the consultation.

A dual-bin printer will mean you will not have to change the paper between prescription and appointment request printing.

When system performance is slow or unreliable, users tend to vent their frustration on the Choose and Book application, however, the problem often lies with how the actual PC has been set up. The national system has performed well, and local benchmarking suggests that when local configuration is correct it has excellent usability. Therefore it is important to have your practice infrastructure checked. Technical advice is available from the Choose and Book website.

By implementing Choose and Book you will have already done some of the work required for access to other NHS Connecting for Health systems such as electronic prescriptions.

Do not rest on your laurels once your practice is using Choose and Book.

Review how well it is working for patients. Do they understand how to make booking, for example?

Lastly, do seek expert help via your PCT and local IT teams if your implementation process hits major snags.

- Dr Davies is a West Yorkshire GP and national medical director (primary care) at NHS Connecting for Health

RESOURCES

- www.chooseandbook.nhs.uk/staff/training/implementation - for implementation guides and role-specific checklists.

- www.chooseandbook.nhs.uk/staff/training - for training manuals and tools.

- Choose and Book - Making it work for you in primary care': a short film on DVD (reference 2232) or CD (reference 2233). Call 08453 700760 to order.

TEN TIPS ON IMPLEMENTATION

1. Appoint one practice team member as project lead.
2. Make a plan of what needs to happen and when.
3. Work closely with the PCT's Choose and Book project manager and local
IT teams.
4. Involve the whole practice team from outset.
5. Consider the impact on the patient's experience.
6. Obtain information booklets for staff and patients,from the PCT or
from websites such as www.nhs.uk.
7. Consider the different ways of using the system to suit local
circumstances.
8. Bear in mind the minimum choice and booking DES requirements.
9. Organise adequate initial and top-up training for practice team.
10. Check that your IT infrastructure is appropriately configured.