Context
In 2002 Delivering the NHS Plan first outlined plans to offer patients who were already on waiting lists opportunities to choose ‘alternative’ hospital providers with shorter waiting times. This idea was tested in a series of pilots and has since developed and expanded. Patients referred by their GP for a non-urgent hospital appointment have had a limited choice of hospitals at the point of referral since January 2006. Since April 2008 patients have been able to choose any hospital listed in a national directory of services which includes NHS acute trusts, foundation trusts and independent sector providers. Patients’ right to choose has now been enshrined in the NHS Constitution.
It is hoped that giving patients a choice of hospital will encourage providers to improve the quality of their services as they seek to attract more patients and the money that comes with them under the Payment by Results reimbursement system (which pays hospitals per case treated).
To support patient choice, an electronic booking system called Choose and Book has been implemented as part of the National Programme for IT. This allows patients to compare hospitals based on waiting time and distance from their home and select an appointment slot at the hospital of their choice. Implementation of this system has been slow and plagued with technical difficulties and resistance from GPs.
Further support has been provided via the NHS Choices website, which was launched in 2007. The website provides more detailed information about hospitals and their performance including indicators from the Care Quality Commission (previously Healthcare Commission) annual assessments as well as patients’ views.
