CHOOSE

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CHOOSE BOOKProblems and solutions
GP and consultant workshopRedwood Education
Centre23rd January 2007
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Thank you to our sponsors.

• Schering Plough Limited
• Napp Pharmaceuticals

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A G E N D A
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19th October event

• INNF
• Shifting the balance

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AIMS FOR THIS EVENING

• To identify the key interface issues between
  primary and secondary care in relation to Choose
  Book
• To provide an update on progress with the
  implementation of the project
• Follow an example pathway from first GP
  attendance to secondary care treatment
• To understand how the system works and to know
  how to use it

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Choose and BookProblems and Solutions
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The Challenge

• IT ??
• Clinical pathways ?
• Managing capacity ??
• New ways of working ?
• New responsibilities
• Clinicians ?
• Support staff ??
• Patients ??

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CHOOSE AND BOOK

• DR JEREMY HALLIDAY
• GP
• CHURCHDOWN

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WHY INVITED?

• use the system
• scathing about its inadequacies
• WHY BOTHER?

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Car Dealership
Dentist
Grocery Delivery
Tree Surgeon
Solicitor
GP
Schools
Mortgage Adviser
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• WHEN WOULD YOU LIKE YOUR APPOINTMENT?

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• HOSPITAL
• NOTHING
• WE WILL LET
• YOU KNOW
• APPOINTMENT
• HASSLE

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• PROBLEM
• CHOOSE FROM SYSTEM
• WHERE
• WHEN
• APPOINTMENT OF CHOICE

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• Mrs G.
• ENT problem
• Non-resolving
• Not urgent but problematic
• Going on holiday in a few weeks
• Frenchay one week!!!

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• Mrs T.
• Chest problem
• Non-resolving
• Urgent appointment
• Oxford 10 days

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PROBLEMS PROBLEMS PROBLEMS

• The IT has to work
• Health inequalities
• Informed middle classes benefit most
• Creative destruction of the NHS
• Potential to destabilise hospitals (Sutton
  Colefield)
• Left with more complex, chronic problems and
  stable income disappears (THR, cataracts, hernias
  etc)

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THE SECONDARY CARE EXPERIENCE

• James Bristol

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DIRECT AND INDIRECT BOOKING EXPLAINED

• Jenny Hill

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Overview

• National and local picture
• Known issues
• The move to direct booking
• Clinical Assessment Services (CAS)
• Patient journey

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National and local picture
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Known issues

• Finding services effectively not sophisticated
  referral advice
• Format and timely submission of referral letters
• Booking office phone lines
• Patient confusion
• Robustness of the application
• Integration with practice and hospital systems

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IBS vs DBS
GP and patient agree referral required
GP and patient agree referral required
Referrer opens Choose and Book
Referrer opens Choose and Book
Referrer selects priority and searches Directory
of Services by specialty and clinic type and/or
named clinician
Referrer selects priority and searches Directory
of Services by specialty and clinic type and/or
named clinician
Referrer selects appropriate service(s)
Referrer selects appropriate service(s)
Book now or later?
Referrer prints appointment request and password
for patient
Referrer searches for appointments for relevant
service(s)
Now
Later
Patient phones booking office of chosen service
Referrer prints appointment request and password
for patient
Patient chooses date/time Appointment booked
Booker offers patient choice of date/time in
clinic(s) relevant to chosen service
Patient books with member of practice staff
Patient books online at www.healthspace.nhs.uk
Patient books via national appointments line
Patient chooses date/time Appointment booked
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Clinical Assessment Services

• For some specialties, outpatient appointment is
  not always next step for referred patient
• Clinical Assessment Service decides pathway
• Virtual booking made into CAS
• Hospital Trust responsibility to contact the
  patient once pathway decided
• Important that referrers understand the
  distinction

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Clinical Assessment Services

• Current CAS specialties
• Haematology
• Ante-natal
• Diabetes
• Future CAS specialties
• Thoracic (sleep studies)
• Nephrology
• Gastroenterology
• Directory of Services is key

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OPTION ONE
B O O K I N G S
Booking office
Referral actioned on line
Referral printed and decision template attached
Referral received on line
Booking confirmed or rearranged
Referral decision written on template
OPTION TWO
Medical Secretary
Referral actioned on line
Booking confirmed -letter
Referral received on line
Referral printed and decision template attached
Referral decision written on template
Or booking rearranged
OPTION THREE
Consultant
Referral received on line
Referral actioned on line
Booking confirmed -letter
Or booking rearranged
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THE PATIENT PATHWAY FROM START TO FINISH

• Jenny Hill

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GROUP DISCUSSIONSPositive issues andoutstanding
concerns?
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FEEDBACK
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SUMMING UP AND CLOSE
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Let us know what you think about our web site and
what information you would find helpful
Irwin.Wilson_at_glos.nhs.uk
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NEXT EVENTWednesday 25th April6.30 for 7
pmForest of DeanPALLIATIVE CARE