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by Edward Picot
20 July 2007

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Diary of a practice manager: not the smartest card in the pack

We’ve been doing Choose and Book since the start of the year. The GPs don’t get involved in the booking process, they simply send the patients to admin, usually to me.

The first couple of times I used the system, both I and the patients concerned were very impressed with it. They went away with their appointments made, and the bookings seemed to be much earlier than they would have been under the old method.

Since then, one or two problems have begun to emerge. You can’t book named consultants. Great Ashbridge is no longer accepting orthopaedic bookings. Sometimes the connection is painfully slow; sometimes it doesn’t work at all.

At the moment, we only have two smartcards in the surgery. One of them belongs to Jack, our main doctor, and the other one belongs to me. Jack’s hands­off attitude towards Choose and Book is epitomised by the fact that his smartcard resides alongside mine in a shabby brown envelope in my “Things to Do” tray.

Today, Jack wanted me to Choose and Book an ear, nose and throat appointment for a boy called Kieron. I fetched my shabby brown envelope, and led Kieron and his mum to the spare office.

The computer hadn’t been switched on yet, because I’d been working in reception. “You’ll have to bear with me while I get logged on,” I said. Kieron stared at me round-eyed, evidently awestruck by my technological savvy.

The computer played the Windows XP signature tune, then froze. The eggtimer sat in the middle of the screen and wouldn’t go away. After an awkward pause of three or four minutes, I told them I was going to switch off and start again.

“Computers can drive you mad, can’t they?” said the woman sympathetically. Kieron, clearly bored, started to drum a little rhythm on the floor with his toes.

This time the computer started properly. I slotted in the smartcard and entered my password. A message appeared: “Incorrect PIN. You have two attempts left before your card is locked.” I put in the password again, really carefully. “Incorrect PIN. You have one attempt left before your card is locked.”

I know what it is, I thought. I’ve got caps lock on. I pressed caps lock and tried again. “Incorrect PIN,” said the computer. “Your card is now locked.”

Kieron was till tapping. “Pack it in, Kieron,” said his mum.

“My card’s just locked me out,” I confessed. “I’ll have to get it unlocked before I can do anything else. Can I ring you later?”

“Has that card got your picture on?” said Kieron, still tapping. “It doesn’t look like you.”

“Be quiet, Kieron. Come on. The man’s going to ring us.”

Kieron and his mum departed, and I sent an email to the primary care trust asking them to unlock my card. Only after this did I remove the card from its slot. It wasn’t my card at all. It was Jack’s.

Like I said, some days it works better than others.