As a GP I share Azeem Majeed's frustrations that many obvious
information technology applications are either unavailable or do not work
effectively and are often not user friendly. The delay in the introduction
of a single national system for encryption is responsible for some of
these problems.
I would disagree with Prof Majeed's statement that online booking
should not be seen as a priority. I am convinced that it is crucial to the
development of IT within the NHS. However, it requires a clinical
component to be core to its development otherwise it becomes an
administrative tool with limited benefit to the patient. This clinical
component is the development of referral protocols.
Direct online booking from a GP surgery onto an out patient
appointment list will ensure that patients are aware of their appointment
time at the time that they are referred and involves the patient in the
booking process. This will eliminate the numerous phone calls made by GPs
and their staff to chase up referrals that have not yet generated an
appointment or where the appointment letter has been lost within the
postal service.
The major benefit of direct booking, though, will be derived from the
development of agreed protocols to determine the criteria required for
referral for a particular clinical problem and obtain an appointment. This
will require GPs, consultants and other practitioners to discuss and agree
these criteria. This will result in a culture shift within secondary care,
as it is based on the need to end consultant vetting and prioritisation of
referrals and rely on the agreed referral criteria. If the referral
criteria are not met, protocol development also places a responsibility on
secondary care to offer advice on clinical management for the patient that
can be delivered either by the GP or other practitioner.
Finally, protocol development also allows for the development of
advice and guidance as an alternative response to an out patient referral.
This enables advice to be formally offered by the consultant without the
need for the patient to attend hospital, thus permitting the GP to retain
resonsibility for the care of the patient.
Rapid Response:
Direct booking protocols
As a GP I share Azeem Majeed's frustrations that many obvious
information technology applications are either unavailable or do not work
effectively and are often not user friendly. The delay in the introduction
of a single national system for encryption is responsible for some of
these problems.
I would disagree with Prof Majeed's statement that online booking
should not be seen as a priority. I am convinced that it is crucial to the
development of IT within the NHS. However, it requires a clinical
component to be core to its development otherwise it becomes an
administrative tool with limited benefit to the patient. This clinical
component is the development of referral protocols.
Direct online booking from a GP surgery onto an out patient
appointment list will ensure that patients are aware of their appointment
time at the time that they are referred and involves the patient in the
booking process. This will eliminate the numerous phone calls made by GPs
and their staff to chase up referrals that have not yet generated an
appointment or where the appointment letter has been lost within the
postal service.
The major benefit of direct booking, though, will be derived from the
development of agreed protocols to determine the criteria required for
referral for a particular clinical problem and obtain an appointment. This
will require GPs, consultants and other practitioners to discuss and agree
these criteria. This will result in a culture shift within secondary care,
as it is based on the need to end consultant vetting and prioritisation of
referrals and rely on the agreed referral criteria. If the referral
criteria are not met, protocol development also places a responsibility on
secondary care to offer advice on clinical management for the patient that
can be delivered either by the GP or other practitioner.
Finally, protocol development also allows for the development of
advice and guidance as an alternative response to an out patient referral.
This enables advice to be formally offered by the consultant without the
need for the patient to attend hospital, thus permitting the GP to retain
resonsibility for the care of the patient.
Competing interests:
None declared
Competing interests: No competing interests