"Two referrals to be told go back to beginning!"

About: Devon Access and Referral Team (DART)

(as the patient),

Having waited for over a week for a reply to my doctor`s letter marked `urgent` I finally received a pre-printed letter from DART. After ringing 3 times I managed to talk to someone only to be informed that it would have to be referred to their doctor.

An hour later I was informed that their doctor had made an arbitrary decision that I did not qualify under the NHS despite the fact that he did not have before him all the medical evidence available. I was then told to go back to my GP and start again.

What a waste of my time, their resources and certainly not helping me whilst I am in pain and cannot lead a normal daily life.

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Responses

Response from Project Support Manager - Devon Referral Support Services, Devon Access & Referral Team (DART)

Dear ‘pinballwizard’,

Thank you for taking the time to share your experience of using the DART service, I can only apologise that you were unable to get through on the phone at your first attempt.

From the information in your post it sounds as if your referral relates to the Low Priority Treatments Policy, which has been in existence for many years. The Policy determines those procedures which are not normally funded by the NHS. The current guidelines have been developed with the support of GPs and Consultants. Please find further information at the links below:

Low Priority Treatments Policy - February 2011 (http://www.devonpct.nhs.uk/Library/Treatments/TP02_Low%20Priority%20Treatments%20Policy_%20Final%2007.09.2011.pdf)

At DART we seek further advice from our GP Support Team on any referrals that may be directly affected by this policy. Your GP will have been informed on the next steps in your treatment. If you need further clarification and would prefer to discuss this by phone please contact me on 01626 883712 or on our Choose and Book Helpdesk email address cab.helpdesk@nhs.net. I work from Monday to Friday between 9am and 5pm.

I can appreciate it must have been frustrating to be asked to call us and then to be directed back to your GP so please accept our apologies for any confusion caused and I hope you get a resolution soon.

Kind regards

Gemma Tremlett

Update posted by pinballwizard (the patient)

Apologies are all very well but I still have not received replies to the questions I submitted on DARTS website. For members of the public who in fact are paying for all of this there is a distinct lack of information on the DART website.

I find it quite inconceivable that one anonymous person can act as judge and jury and condemn a person to a limited and painful life and where there is no appeal against such a decision without at the very least asking for further information. Surely it is self evident that if a GP submits a referral then the GP considers it necessary.

Response from Project Support Manager - Devon Referral Support Services, Devon Access & Referral Team (DART)

Dear ‘pinballwizard’,

Thank you for coming back to clarify the issue with us. If you would like, you are welcome to phone me and we can talk the issue through over the phone and I can investigate further if necessary. My number is 01626 883702 – I work Tuesdays, Thursdays and Fridays from 8 until 4. I will endeavour to answer as much as I can here though.

I’m afraid I don’t know what questions you have submitted to the website, and without your name it will be difficult for me to find out who in the organisation is dealing with those so I will instead focus on the questions you have asked here.

The Low Priority Treatment Policy was put in place because the NHS simply cannot afford to pay for every possible treatment and so treatments are prioritised and those that come lower down on the list are subject to greater scrutiny before being approved. In other words, some treatments are not automatically carried out as is the case with most treatments/procedures. The treatments that appear in the policy rarely change but the criteria for approval can. The criteria are produced in response to the available treatments for the condition in question and exceptions can be made for certain patients. There is more detail in the policy itself about why it exists, how it should be applied and how to appeal. I’m afraid I cannot provide a link to the document as we are in the process of updating our website so it wouldn’t last for very long. However, your GP will be able to access a copy or if you phone me, I’ll be happy to post you a copy.

With regard to an appeal, for patients whose cases are not a straightforward yes/no, there is a panel that your GP can send your information to. The panel is made up of a number of people, including GPs, who will review your case in detail before deciding whether or not to forward the referral. The fact that the panel exists highlights the fact that clinicians do not always agree on a diagnosis or treatment plan which I imagine is the reason that your GP referred you and another returned the referral. Your GP should be familiar with this policy and the appeals process and so it might be advisable for you to contact him/her to discuss the matter further.

I cannot influence the outcome of your referral but I would very much like to provide you with an explanation of DART’s actions that meets your satisfaction so please do get back in touch if you have further questions.

Best wishes,

Susan Pearce

Updates, changes and questions related to this story