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Healthcare at your fingertips - a Choose & Book roadtest

NHS IT - money, well, spent...

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The NHS's new Choose and Book system, it says here, is a "national electronic referral service which gives patients a choice of place, date, and time for their first outpatient appointment in a hospital or clinic." Ever wondered why they're called "patients"? Well, in recent weeks The Register's Mystery Croaker has had the opportunity to road test Choose and Book, and to find out.

One of Choose and Book's USPs is that it empowers patients, allowing them to book their appointment just as easily as their GP can. So we should perhaps have smelled a rat when Dr Dan tried and failed to book us in, and instead thrust a piece of paper in our hand with the words "Phone this number and sort yourself out."

Or alternatively, seeing the appointment request letter includes login details, use the Internet. Here, all goes swimmingly (as happy patients tell us) at first. We change the flakey login details (not quite 'admin-password', but close) to something slightly more secure, and see that the system has correctly identified us, Dr Dan and our chosen hospital, and that's there's a waiting time of approximately 45 days.

Check the box next to the hospital, and proceed to book appointment. Appointments are available every Monday for a five week period, starting from about 45 days away, at 15 minute intervals between 8.30am and 10am. Check the first one, click book.

The system goes away and thinks about it, then apologises. The slot's already taken, and it disappears from the list. OK, try the next one - pause, thinks, no, sorry that slot's already taken. And so on. Feeding the obsessive completism of his inner geek, the Croaker cuts swathes through the available appointments, none of which actually are, until Choose and Book gives in and confesses that it's not possible to book an appointment online, and we should phone the number instead. Spoilsport - there were about six slots we hadn't tried yet, too.

Fine, phone the number. A recorded message claims they're experiencing high demand, and suggests we might like to try the Internet. Or come back another day. Or you could try holding for an operator. But they lie - an operator answers almost immediately.

And asks us for our login details, and for our new, secure, password. Which is therefore now insecure. She attempts to book an appointment. A couple of times, explaining that the system she's using is precisely the same system that the public uses. So, er, she's logged in as me? Right...

But, she explains, it's not precisely the same system, because after a couple of failures to book, her system will kick up an error message explaining what's going on. Which it does - the connection to the particular hospital isn't working meaning, possibly, that the original list of available appointments was imaginary, wishful thinking, and/or hardwired into the Choose and Book system. And that it's only pretending that it connected to the hospital when it tells you the appointment is already taken.

OK, so what do we do now? They send in an error report, and they reset the system, the operator cheerfully tells us. And then we try again later? Yes, quite a bit later. "It takes 48 hours, so try again in two days." Healthcare at your fingertips - now wash your hands.

Four days (i.e. 96 hours) later we try again, eliminating the first half dozen "available" appointments before phoning the nice support people. Again we're assured that the system they use is identical to the one used by the general public, but this time we get confirmation - they don't see the six we'd already eliminated in this session, and offer us the first of the ones we left as the first available.

It isn't, of course, because the connection is down again. Or still. This time around, along with the profuse apologies, we're promised we'll get a note attached to our account stressing we've been blown out twice now, and should therefore be looked after. So how does that work? Have we been upgraded to Club? Will a broken connection magically repair itself when we next try (in, of course, 48 hours)? Or will they make a connection especially for us? And then break it again after we've successfully booked an appointment? Whatever, 48 hours later it all works, possibly just for us, and we get the appointment. Best of luck, the rest of you.* ®

* Two weeks on, we sit before a doctor. "Have you had the scan?" "Er, no..." "Oh, you should have had a scan before you saw me. You'll have to book an appointment for one." "Right..."

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