"What is the point of DART?"

About: Devon Access and Referral Team (DART) Honiton Hospital

(as the patient),

My doctor saw me two weeks ago and one of the things we talked about was a small mole on my face. She advised me to have it removed and said this could be done at Honiton Hospital and she would arrange it.

A week or so later I received a letter asking me to ring DART quoting my URBN, which I did. The lady who answered the phone was very nice but she couldn't give me an appointment, she had to contact someone else. A few days later I had a call from Seaton Hospital and an appointment was made for me to go to Honiton Hospital.

This was an improvement on the previous two occasions my family has used DART. On these occasions it was my daughter who needed appointments, the first for an heart scan, the second for a minor eye operation. On both occasions over a week passed after she had seen her doctor to receiving the DART letters, and again on both occasions when she telephoned, she was told she didn't have a choice of hospitals and an appointment would be sent to her through the post.

All DART seems to do is put another time wasting link in the chain between the patient seeing his or her GP and getting an hospital appointment.

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Response from Susan Pearce, Project Support Manager, DART (Devon Access & Referral Team), NHS Devon

Dear ‘Prince’,

Thank you for taking the time to contact us and let us know about your experience of using DART. We value all feedback and try to use it to improve our service.

I am sorry that we here at DART were unable to book your appointment for you; I appreciate that this is what you would have expected when you phoned in. The vast majority of services in Devon can be booked through us as their appointments are available on the Choose & Book system. Unfortunately, there are a few services which are still booked locally using paper diaries or local systems and we do not have access to these appointments. We are working with the hospitals to try to get all appointments available to us and I know that the service you are being referred to should be available to us soon. In the meantime, all we can do is transfer patients to the person who holds the diary which I realise is not as convenient as it should be, particularly if we were unable while you were on the phone.

Regarding the time it took for you to receive DART’s contact details for your referral and your daughter’s, this is the responsibility of the GP surgery. There are times when your GP will want to carry out tests or other checks before making a referral which can account for delays but I cannot say if this is true for you and your daughter. If you feel that this is not the case, please let me know, by reply to this post or by phone, which surgery you are registered with and I will be happy to contact them and pass on your concerns anonymously.

I believe that the reasons behind your daughter not being able to book her appointment through DART are two separate ones. When she was referred for a heart scan, she may well have been passed on to a Clinical Assessment Services by the DART team. These are in place at some cardiac units in the area because there are a number of diagnostic tests that may be required before you meet with a consultant, and these vary from case to case, so the hospitals ask that they book the appointments and can therefore arrange the timings so that your results are available when you first meet with the specialist. This is currently how it works at both the RD&E and Torbay hospitals. They ask for 14 days so that the consultant can read your referral letter and they can set up the relevant diagnostics appointments as described above.

However, this system is not in place at all hospitals and so the reason patients are asked to phone DART is so that they can be offered a choice of hospitals. Taunton and North Devon do not use Clinical Assessment Services for their cardiac appointments and so we are able to offer a choice of appointments while patients are on the phone.

There are no such systems in place at any of the local eye departments so when your daughter was referred for her eye surgery; I suspect that we were unable to give her an appointment because there were none available on our system at the time. This happens in most specialities at some time or another and is due to a large number of referrals being received in a short time span causing all of the available appointments to get booked and we have no choice but to forward the patient’s details on to that hospital so that they can book the appointment as soon as more become available. Sometimes this involves the hospital organising an extra clinic to accommodate the waiting patients. This is not how the system is supposed to work and we realise that it is very frustrating for patients. We keep in constant touch with the local hospitals regarding this issue and we are doing all we can to help them resolve it.

As I said earlier, we are working with the hospitals to get as many services as possible using the online appointment system but it is a slow process and we are doing our best in the meantime. I’m sorry for the lengthy reply but I hope that I have answered all of your queries. If you have any further concerns, please do not hesitate to contact me.

Kind regards,


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