Abstract
Traditionally, general practitioners (GPs) would write a referral letter to a hospital consultant requesting an appointment. The choice of hospital and specific consultant was left to the expertise of the GP. This referral would be vetted by the consultant and prioritised into a routine or urgent appointment. However, in 2005 a new system, called 'Choose and Book', was introduced. Once the patient and GP had agreed that a hospital consultation was required, the GP completed a referral letter and provided the patient with a code to access a telephone or internet booking system. This allowed patients to choose both the hospital they would attend and the consultant by whom they would be seen. Booking rules were constructed to ensure that appropriate consultations were offered.
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