Talk:Choose and Book

User Experience

There are comments and edits about User Experience which are contentious. I'm trying to dig out information that is both validated and in the Public Domain so that we have a truly impartial view. Sadly comments seem to fall into one camp or the other.

Advice on how to represent this is welcome.

Most of the negative press appears to emanate from those with a vested interest in its failure. Most of the published positives are usually dismissed as 'puff pieces' from the DH.

I'm too close to this to be truly objective, but most of the negative comments appear to be based on tabloid comments rather than facts, while I see a significantly positive view expressed from users.

Somehow we need to distinguish between 'Users' (almost all are NHS employees or contractors) and Patients (who, in theory can access the system, but have very rarely done so). -Pimdip 22:57, 31 August 2006

If we try and fail to find any trustworthy sources, then I think we need to be brave and just remove the content. It's a contentious issue, but the verifiability principle does point that way. --VinceBowdren 23:36, 31 August 2006 (UTC)

Instead of deleting uncited content, which admitedly you have done qute a bt recently, try and look for sources. I know my contributions to user experience were not taken from tabloids and is user experience. I did however add the citation needed tag hoping another contributor would do so. Understandably, for such a recent subject, it is hard to find sources oher than contributors who are themselves users. I'll be glad to relate my experience as an impartial technician after my next install. Screenshots maybe ? we'll end up with an empty Wikipedia if you continue like this ! Captain Scarlet and the Mysterons 05:47, 1 September 2006 (UTC)

I've just published a paper on patient experience of Choose and Book that might be what people are looking for. If there are no objections, I'll put a citation in. The reference list has some further citations of possible relevance. Bondegezou (talk) 12:35, 1 August 2008 (UTC)

OK, I've added that citation, but as there's a clear conflict of interest, I encourage other editors to review and re-write that addition. Further references in the paper cited may provide more useful material. There is an extensive literature criticising Choose and Book and that should be reflected in the article. Bondegezou (talk) 16:33, 1 August 2008 (UTC)

Good relevant reference, but might need balancing about whether the lack of choice is due to the application, or provider Trusts not publishing their services effectively or in sufficient quantity. Might also be time for a subsection on poor user experience where providers proactively hold back appointment slots from CaB to make their 18 week figures look better? Pimdip (talk) 20:03, 1 August 2008 (UTC)

Poor programming and testing

Since I have starting commenting on the system, I have related to my experience of the software if one can call it that. Would screenshots be approrpiate to the article to show to inherant flaws of the installation prossess of IA and RA, both core components of C&B (creating cards and printing cards) ? Captain Scarlet and the Mysterons 07:49, 1 September 2006 (UTC)

I've found a third party comment on C&B [1] Captain Scarlet and the Mysterons 07:50, 1 September 2006 (UTC)

Thanks Captain Scarlet. Yes, I can find other similar quotes (and agree about lack of proper testing) , but want a balanced article that includes both viewpoints; both have validity, but of the users I know, only about 5% are unhappy with CaB (once it's been properly implemented), whereas 90% of the coverage is negative. NPfIT have yet to publish any of the surveys I've seen, even though they were hugely favourable (go figure).

You seem to have a technical knowledge, so will understand the point that the vast majority of technical issues with CaB are instability of the Spine, RA, N3 or the upgraded versions of EMIS/iSOFT/InPS etc. CaB is a part of NPfIT, as are RA etc. RA is not part of CaB if you see what I mean. (The confusion of interdependency I know, but the equivalent would be to slag off Internet Explorer or Firefox because an ISP has ropey connectivity?)

In addition, a significant amount of complaints are non-technical, but relate to the lack of capacity in Outpatients which has always been a problem, but was hidden by byzantine paper-based processes.

How about we cite your e-HI reference for the detractors, and add this link [2] with a patient relating a positive experience?

As a Wikipedia article I'm keen that this doesn't become another "The Sky Is Falling" story, nor a bland Puff-Piece for CaB. Pimdip 14:17, 1 September 2006 (UTC)

I understand the article musn't become a slating of the NHS, I'd be very badly placed to do that. Although it is discouraged to edit articles concerning companies we work for for, I deemed it important to contribute to such an important article. Something that will in time be part of our healthy lives. I can't comment on patients reactions as I'm not a doctor (doctor! doctor!). I can only objectively comment on the system itself, how it was designed and what NHSIA/CfH expect of plebs in order to get the system up and running. I know the Information Authority and the Registery authority aren't C&B but these are the names of authorities that have their names stamped on IA and RA and it is them who have delivered the software; card making + card printing. Pffeeew breathe. I am interesting in relating pure facts, with screenshots if possible (not quite now, as as an NHS employee I obviously left for home early on a Friday). what I'd be more wiling to slag off if I had no morals would be the total sham of the installer which is nothing more than a collection of 4 installers, which then require accepting three different java popup messages (to access NHS Portal and tick session role). I could also add having to enable all activeX (to install MyID). It's just shady, cheap and quick work of an installer. Getting the certificates, adding the trusted sites is a little taster of things to do once the install is done. Now these are negative comments, but in no way PoV and represent a description of the system, anyone looking into it would agree that in an IT study of the system, it's not up to scrap. The idea is good and merits being forced upon us, but not the way it is at the moment. Captain Scarlet and the Mysterons 15:45, 1 September 2006 (UTC)

Can't argue with that CS! For the time being, until we can get our hands on impartial cites pro & con I'll edit them out and try to replace with some more objective comments. Be nice if you would be prepared to footle with whatever I put there. Pimdip 18:18, 1 September 2006 (UTC)

I have no problem backing down until we can find sources, or proofs. From an engineering point of vue (that's not a person's PoV but Computing sciences' vue, it is evident that the prossess is clumsy and badly programmed. there must be a way to impartially comment on the prossess without judging it ? Captain Scarlet and the Mysterons 19:13, 1 September 2006 (UTC)

R/V

Choose and book is a policy of the ENGLISH NHS, therefore stating "United Kingdom's NHS" is simply incorrect. There is no such entity as the UK NHS. Panthro 21:30, 1 September 2006 (UTC)

Maybe not, but the NHS as we know it covers England and Wales. There also is NHS in Scotland [3] ... Captain Scarlet and the Mysterons 08:36, 2 September 2006 (UTC)

Actually Panthro's right. There are 4 separate Health Services now; Wales is as separate as Scotland's. I'll have a squint through NHS articles and check for the inaccuracy Panthro pointed out.Pimdip 09:52, 2 September 2006 (UTC)

According to the choose and book website, it "has been introduced across England. It will eventually be available to all patients.". Sounds like it's also going to cover everywhere else as well as England. --VinceBowdren 13:04, 2 September 2006 (UTC)

I have been through all the articles in Category: NHS and changed the inaccuracies re: UK NHS. I am aware that some NHS bodies/schemes/policies are implemented in both England and Wales, so I apologise for if I made a mistook in some. Also, as Choose and Book is part of the NPfIT (part of the NHS Plan 2000) - Scotland is not covered as it is not accountable to the DoH. See National Programme for IT Panthro 21:32, 2 September 2006 (UTC)

But patients are no better off

Choose and Book seems to be another way of preventing patients from becoming statistics on lengthy waiting lists. After 6 weeks with no treatment my doctor tried to use C&B to make an appointment with a neurologist. Nothing available without waiting 3 months or more. So he booked me to see an orthopeadic consultant - only a 2 week wait ! The orthopeadic consultant waited for 12 days and then rejected my appointment as he did not treat my condition. So - a complete waste of 2 weeks. Now I have to go back to the doctor, make another Choose and Book appointment, wait nearly 3 months . . . Two months after first seeing my doctor I have had no treatment whatsoever and it seems that the best I can hope for is a 10 minute appointment in a further 3 months. Pathetic. Aidepiki 23 October 2006 (UTC)

I'm afraid one self-reported example isn't sufficiently 'encyclopaedic' to go into the article, but if there has been independent reporting of doctors trying to reduce their waiting lists by deliberately getting their patients pointless appointments, then we should write that up (with the appropriate citation).

On the other hand, it's not obvious exactly what was the cause of your appointment being booked and then cancelled. It could be any of the following:

• Your GP deliberately booking you an appointment he knew wouldn't help you - possibly due to pressure to reduce waiting lists.
• Your GP booking you an appointment which he thought would help you, but which wouldn't (and this could have been predicted had the GP known more). Perhaps C&B, or the overall system of referrals/specialists/appointments needs tweaking to communicate back to the GP that trying to book an appointment with this particular specialist won't achieve anything; but this is just speculation now.
• The orthopaedic consultant could have helped, but mistakenly rejected your appointment due to insufficient or misleading information in the referral notes perhaps. Again, I'm speculating but if it is something along these lines, then maybe C&B could be tweaked to make sure all the relevant information gets through. Or maybe that information transfer is done separately from C&B; we just don't know.

Also notice that we don't know why there is a three-month wait for a neurologist appointment in the first place; nor the reason for the delay between the appointment being made and it being cancelled, nor why an appointment could not be made with a different neurologist (e.g. at a different hospital) any time sooner, etc etc. --VinceBowdren 12:11, 23 October 2006 (UTC)

Two observations.

CaB highlights the lack of capacity in Hospitals that's been hidden by paperwork for years. Many specialties have no slots available within the 13 week required timeframe, so when referred manually are double-booked in the hope of cancellations. This is then often followed by 1 or more re-bookings. Always been there. Scandalous, but exposed, not caused by CaB. It also requires GPs to produce the referral letter within 3 days. I've audited Practices where letters are often produced over a week after the consultation.

To Aidepiki, The fact that your local Hospital has awful capacity in Neurology has probably been hidden for years. Now perhaps the Trust will do something about it?

Secondly, when auditing a PCT 2 years ago, we found that the average wait to receive notification of the appointment was 27 days! (we found several over 100 days)

CaB is imperfect, but far better than the reality of manual processes that the service would prefer to hide under the carpet. Pimdip 14:40, 24 October 2006 (UTC)

Cost

The cost of this and other projects are always being mentioned in the press. Is there anything factual we can say about that? —The preceding unsigned comment was added by 81.6.222.229 (talk) 22:02, 30 January 2007 (UTC).

The full contract value was announced as £84M if I recall correctly (will try to find source) but this is too simplistic. The contract includes a small up-front element but the bulk of its value is an undisclosed 'cost per transaction' element to ensure contract value realisation.Pimdip 22:36, 30 January 2007 (UTC)

Patient Choice

I've added reference to the Independent Sector's entry to the CaB market place.

Firstly, do we need a separate 'Patient Choice' entry, as this (whilst strongly linked to CaB) is not entirely dependent on it.

Secondly, do we need clarification on what is a UK 'Independent Sctor' provider?

The time seems ripe as we're already seeing patients leaving their GP surgery with a confirmed appointment at a BUPA hospital (funded through the NHS) and the other big players (Nuffield, Capio et al) will be onstream in the next few weeks.

Thoughts? Pimdip 23:03, 30 January 2007 (UTC)

Booking via TV

Is this part of choose and book? See this article here.

No. This is a facility offered by EMIS (a GP Clinicial Systems Supplier) and only works for GPs who use their system, and relates to booking GP appointments (Choose and Book is for booking from the GP into Outpatients.) The main challenge of NPfIT products is to work across different propietary systems - much easier to do it within one single product.

Ironically, GPs in my organisation piloted Digital TV via a local cable TV company back in the laste 90s. What a short corporate memory we have :-( Pimdip 18:56, 24 July 2007 (UTC)

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