We hear so much about Choose and Book; it is definitely a good IT tool for the GP's desk. But, as usual in the NHS, such ideas are put in place well before the system is fully tested. It is like asking someone to navigate the plane before he or she has the full training.
In my experience, some secondary providers are not fully trained or do not have adequate staff. My own staff have learnt to overcome such difficulties by not using these providers.
Sometimes the patient experience is like going to the airport to find the flights are overbooked. We have had suppliers telling patients to come back to us and rebook the appointment. It is easier with the secondary providers who have fully trained staff.
The greatest advantage of Choose and Book is that one does not forget the referral.
Finally I should mention that the system is not 100 per cent fool proof.
I happened to refer one of my patients to a local provider while the patient was with me. I accidentally entered the wrong NHS numbers.
To my surprise I found that the patient's address was somewhere in Devon, miles away from where I practice. I asked the patient when he had moved to Devon. Then I realised it was not my patient and shredded the print-out.
It seems a GP, or anyone with a smartcard, can get access to details of patients not registered with them.
Dr Sivaram Devaraj, Twickenham, Middlesex.