Case study: Devon Access and Referral Team

The Devon Access and Referral Team (DART) is a new telephone service for booking hospital appointments. DART have been working with Patient Opinion to hear how patients are finding the new system. Business Manager John Tovey discusses the impact online feedback has had

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What is your role at DART?

My role is Business Manager. I am responsible for our patient/practice helpdesk team, communications between DART and patients/the NHS and also for reporting on all aspects of DART performance. I supply data out to GP practices on their usage of the DART service and I brief the DART management board on our performance.

How are you using Patient Opinion?

We use it for timely feedback from patients on their experience of booking appointments through DART. DART is a new service which was set up in May 2010 and we knew that we needed some way of getting feedback quickly in order to gauge the effectiveness of our service from the patient’s perspective.

What is involved in doing this?

When a patient is referred the practices send/hand them a pre-formatted letter, which mentions feedback on Patient Opinion. We deal with nearly 10,000 referrals a month so a lot of patients are seeing the details of how to feed back to us.

In reality only a small proportion choose to do so - usually it is those who have had a problem that take the time to tell us about it. This is useful in one way because it means that most of the responses are an opportunity to learn about problems. However it does mean we don’t often hear from those patients who are satisfied with the service.

How much work is it?

Most of the work involved is investigating the comments, looking for root causes and ensuring we give the patient a response which leaves them feeling we have listened and are trying to improve things for them.

What obstacles have you encountered?

One of the downsides of patients being able to comment anonymously is that we are sometimes a bit frustrated that we cannot fully investigate a comment. We do appreciate though that some patients are more comfortable with remaining anonymous.

How have you involved other staff in the department or trust?

We have kept our local PALS team and the PCT Customer Service manager up to date with the things we have done through Patient Opinion. We also give feedback to the teams of people who talk to patients if we think there is something we need to change in our internal processes.

Has there been any impact for staff? How have they reacted?

We have made some changes to the way we operate the call centre as a result of feedback from patients. Early feedback identified for us that our small teams of call handlers (we have teams of 6 people who deal with calls for particular specialties) were inadvertently blocking any calls from being received to their team on some occasions. This was basically because they all made themselves unavailable at the same time to do other administrative tasks and weren’t aware that their colleagues had all done the same thing. We started getting some patients comments about being unable to get through at a particular time and this led us to make changes to the phone system to enable the teams to automatically always have someone available to take calls. The staff were happy to implement this change and to know that they could no longer inadvertently prevent patients from getting through.

Has there been any impact for patients?

We have certainly streamlined the way our phone system works as a result of feedback from patients and we know from monitoring the issues logged via Patient Opinion that some of the grumbles made about the way calls were queued and answered have now disappeared.

We would like to think that this reflects the improvements we made within the first few months after DART went live. We have also been able to follow up on specific issues for some patients where they have been prepared to give us enough detail to do so.

Have you had any really critical feedback? If so, how have you handled it?

Certainly the overall flavour of the responses has been generally a bit negative. It is nice to see the odd positive one and we do circulate those around the team as it is a morale boost. If we have particular problems we have avoided discussing it directly with members of the team but rather have talked to them about the planned changes and used the feedback in general terms to reinforce why changes are necessary.

What have you learnt from using Patient Opinion?

That despite thinking that you know how your processes are supposed to work, it is only when you get feedback from patients that you can find they aren’t working that way at all. Organising services in the NHS is a big and complicated task and there is always potential for things not to go to plan. You try to anticipate what is required but you really need direct feedback in order to identify and quickly fix problems.