The future of NHS England’s Choose and Book programme

NHS England today clarified the future of its Choose and Book programme, following an article in the Observer newspaper at the weekend.

Beverley Bryant, Director of Strategic Systems and Technology for NHS England explained the contract on Choose and Book – introduced in 2004 as a national electronic appointment booking service that provides patients with a choice of place, date and time for first outpatient appointments – is coming to an end.

“A new NHS e-Referral Service will supersede it later this year,” she said. “This will build on the success of Choose and Book and lessons learnt to provide a more efficient service that better meets the needs of the NHS and our patients.

“When Choose and Book was introduced nearly 10 years ago it was a major step forward in creating a central appointments service with the aim of offering patients a choice of appointment at a time and place to suit them.

“As a result, up to 40,000 patient referrals are made through Choose and Book every day and to date over 40 million bookings have been made through the system. But we know that Choose and Book has worked for some and not for others and a combination of electronic and paper referrals is still being used in some areas.

“With the new NHS eReferrals Service we want to build on the successes of Choose and Book and use the lessons learnt. This isn’t about reinventing the wheel, it is about taking the next step.

“This is part of NHS England’s commitment to making all referrals electronic by 2018.

“What we have been very clear on is the need to understand what referring clinicians and receiving organisations want from the new system. Managing a mixed economy of paper and electronic referrals is onerous for hospitals and the lack of total slot availability makes it difficult for referring GPs to move away from paper.

“We want a system that is quick, easy and beneficial for healthcare professionals to use and ultimately improves patient experience by providing flexibility and choice around the services we offer wherever the patient is.

“When Choose and Book was designed back in 2003 agile, open technologies were not readily available.  A major objective of the new NHS E-Referrals system will be to introduce functionality for patients as well as clinicians to facilitate Choice and to make the whole booking experience more user friendly”

The vision for the new NHS e-Referral Service was launched in June 2013. The announcement kicked off an extensive engagement with healthcare professionals and patients.

Feedback from consultations has helped drive the design of the new service and help develop a system that is simpler to use, adopts the latest technology and provides an improved service for users and better experience for patients, with a view to driving up utilisation.

The new NHS e-Referral Service will harness some of the new technologies used by the most successful IT companies in the world and, using the latest Agile development techniques, will deliver a service designed and assured by the users, that patients want and the NHS needs to deliver modern and efficient healthcare.


  1. Simon Hudson says:

    A danger of easier electronic referrals is the tendency for even more patients to be referred, thereby increasing waiting times as clinics are often at capacity.

    Wandsworth CCG has been doing some pioneering work on inappropriate referral avoidance which complements the eReferral development proposed. NHS England published this as a Case Study here:

    It is hoped that the new eReferral will allow integration with this type of approach and encourage the use of GPs seeking helpful clinical advice as an alternative to referrals.

  2. AR says:

    Dear Sir/Madam

    We are having our assembly on 1st October which is normally attended by 100-150 older residents and I was wondering whether we can get a speaker from e-Referral initiative to give a short presentation, please. We are in London
    Many thanks and look forward to hearing from you

  3. Philip Le Dune says:

    I am indebted to the Guardian for alerting me as a GP to this wonderful new development. Really good to be kept in the loop with things that impinge on my working practice. Lovely.

  4. Raj says:

    I am surprised to read the claim that extensive consultation with Clinicians (GPs) was done before launching the new e-referral system. Neither I or my other colleagues ever remember this actually took place.

  5. Jonathan Darby says:

    In Dudley we have developed a quick and easy to use referral pathway using advice and guidance on Choose and Book which has significantly cut waits to see cardiologists in Dudley and is projected to make significant financial savings for the CCG. We hope to use the system for other referral pathways, but one of the limitations is the file size that we can send using C and B. Can we be assured that the new electronic referral pathway will accommodate significantly large file sizes?

    • Natalie Fuller says:

      Hi Jonathan, the majority of the time when we experience this issue it is because of the way documents have been scanned i.e. the format or the fact that pictures/ logos have not been compressed therefore making the document larger than what it needs to be. Hope this helps.

  6. George Donald says:

    Who is going to pay for using the new C&B / eReferral service?

    In early 2012, whan I was referred for a hip replacement, my GP surgery refused to use C&B because of a dispute over who paid to use the service – GPs or PCTs.
    My referral was sent by post, which added to the longer than 18 week wait.

    Has this dispute been resolved?