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NHS e-Referrals service in poor health from day one

NHS e-Referrals, the replacement for the now retired Choose and Book Service, went live yesterday with a slightly bumpy start.

e-Referrals is a means of booking hospital referral appointments online in a bid to reduce paper-based referrals in line with the NHS paperless drive – the NHS has been challenged to scrap paper in favour of digital alternatives entirely by 2018.

Since 2004, over 40 million referrals from GP to first outpatient appointments have been made via e-Referrals predecessor Choose and Book and it is predicted the new system will save 20 per cent in costs for NHS England.

However, e-Referrals is off to a shaky start with over 30 known issues on its second day of operation, including loading delays and search problems.

According to the Health and Social Care Information Centre (HSCIC), it is currently in the process of resolving the issues.

“It is not anticipated that any of these issues will pose a clinical safety risk, cause any detriment to patient care or prevent users from carrying out essential tasks,” the HSCIC website claims.

“Even though we have done a huge amount of testing, it is impossible to test every possible key stroke and action and new issue may well surface now the system is in use,” it adds.

“Necessary Evil”

Eva Weber, senior product marketing manager at ABBYY, a firm which provides software to organisations to help them digitise paper documents easily, claims that the e-Referrals service is a “necessary evil.”

“The NHS e-Referral Service is a necessary evil to secure the future of our healthcare service. Changing from a manual, paper-based approach to an open, self-referral programme is not an easy transition,” Weber claimed.

“But it’s essential to free up time and resources for our GPs and create more choices for patients,” she added.

Weber claims that the NHS needs to adopt a better system if it is to truly realise its paperless goals and make services such as e-Referrals a success.

“The inability to innovate or transform our NHS services today is largely due to the lack of cohesive, integrated system. What we urgently need is an effective and transparent information management system that also delivers on cost savings,” she claimed.

“It removes the admin-heavy, paper-based booking system, evident in the stacks of filing cabinets that plague many GP’s offices and hospitals.

“With a more unified information system, patients will have the option to access their own health records and opt for self-care services. Patient progress and treatment programmes will directly feed into the system for management teams to review and look at news ways to improve care in the country,” she added.

Michael Allen, Solutions VP EMEA for Dynatrace has commented: “As predicted, the NHS England e-Referral system is already suffering from ‘technical problems’ just two days after being launched – even the service status page isn’t working! The Health and Social Care Information Centre (HSCIC), which runs the system, had already flagged that there were over 30 existing problems with the service – this begs the question, why did the launch go ahead?

It is much more expensive to fix application problems in the field, rather than in the testing environment – not to mention creating more frustration for customers and embarrassment for the organisations responsible.

I’m not sure why the public has been used as guinea pigs in this instance, but ensuring that applications – particularly those that will be used by the public – are thoroughly tested and debugged, with any issues ironed out before launch, is just common sense. Shame it wasn’t followed in this instance.”