"My experience of the new referral service"

About: Devon Access and Referral Team (DART)

(as the patient),

I visited my GP and was told that they recommended I see a consultant. I have only recently moved to the area so this is the first time I've been referred to our local hospitals. I was told that the system now in place for referral to a consultant was the DART team, who I understand liaise between your GP and the hospital to find a convenient appointment. I was told that they would send out a letter to me to instruct on the next steps.

I received the letter last Friday, so called the DART number and was told that as yet no letter had arrived from my GP so I would have to wait. They explained that they would be in touch or I could ring them.

At this point I queried a point printed in the letter about having a choice of consultant. I asked how I would know who to choose given that I have not yet had any contact with a consultant in the area. The person on the phone said that all would be explained once they had the letter from my GP.

What happened wasn't quite like this.

I received a message on my answerphone so I called the DART team and there seemed to be such a big hurry on the phone. It was towards the end of the day so I had to wonder whether the person was desperate to get home! I was immediately offered an appointment at Torbay Hospital in October with a particular consultant. I almost felt from the rush on the telephone call that I couldn't do anything but accept this but I did stop them and I asked what were my choices. The person on the end of the phone said that I could go anywhere in the country, which I don't find particularly helpful. I explained that of the two local hospitals, I would prefer to go to Exeter as my friend had recommended a consultant to me. The person on the end of the line seemed a little reluctant, but then said that they could arrange an appointment with this consultant but there may be a wait. I said I could wait, and was offered an appointment in December.

I have one concern, a question and a suggestion!

My concern with this system is that I felt rushed on the phone call and although the letter states that you have a choice as to where you're referred, I didn't really feel that my opinion was welcomed. I imagine that had I been any more shy or perhaps elderly, I wouldn't have felt comfortable interjecting and would probably have just accepted the appointment whether it suited me or not. I think someone could easily be made to feel flumoxed in this position. I recognise that DART is a new service but I feel that this could be improved.

My question is who made the decision to send me to Torbay initially, and what criteria did they use? I'd find this information really useful, and I'm sure others would to. Is the decision made on a financial basis, or is it about availability of appointments? At times when I've been referred to a consultant in the past, I have been able to discuss my options with my GP and we have made a decision between us. I would certainly prefer that the person who makes a decision like this on my behalf is medically trained, but I suspect that they are perhaps not.

My humble suggestion would be that I wonder if it is possible to list possible options online so that you have time to look at each option and make an informed choice. I understand that not everyone is online but most people are nowadays and this seems like a sensible way to offer choice.

Thank you

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

Dear ‘Colourful244’,

Thank you very much for getting in touch to let us know about your experience of using the DART service and for giving such constructive feedback. We greatly value the opinions that we receive from patients as it helps us to constantly review and improve our service and we are very grateful to all patients who take the time to help us in this respect.

I am very sorry about the service that you received when you phoned us, this is not the level of service that we aim to provide. You should not have been made to feel rushed during the phone call and in making your decision as a result and I would like to apologise for this.

Regarding the choice of hospitals you were offered, again I would like to apologise as you should have been offered a range of appropriate local hospitals to choose from and it should have been explained to you that you can be treated outside of the local area if you prefer. I think you make a good point when you say that some people will be more reluctant to ask questions and, when dealt with in this manner, would have felt obliged to go to the hospital that they were offered rather than querying their options. I would like to look into this matter further and so would be very grateful if you would be able to phone me with a few details so that I can investigate. My number is 01626 883888. However, if you prefer to remain anonymous, I completely understand.

With regard to making a choice of which hospital to be treated at, our protocol would be to not try to influence the patient at all but rather, to the best of our ability, provide whatever information the patient wishes to base their decision upon. For example, a lot of patients wish to be seen as soon as possible and so base their decision on the waiting times at local hospitals and we are able to view the available appointments at the vast majority of services in the area. We do not hold information on individual consultants but we can tell patients which consultants work at which hospital. Patients are then welcome to go and research the clinicians they are interested in seeing, by talking to people they know or their GP, before phoning us back and we can then book them an appointment with the consultant that they have chosen.

As it is not the way we aim to deal with patients, I can’t be sure of why you were offered Torbay hospital in particular but I suspect it is because it is the nearest hospital to you as many patients do choose the hospital that is easiest for them to get to. We certainly have no incentive, financial or otherwise, to book with any particular hospitals so I can only imagine that it was the nearest one to you. However, as I’ve said, this is not the way we should be dealing with patients so I can’t be sure of why this decision was made.

I agree that it would be ideal if there were an online directory of services available to patients to help them choose their hospital. Unfortunately, when this was tried in the past it transpired that many services are too specialised for a simple list to be created of what ailments can be seen where, and patients ended up choosing inappropriate services (through no fault of their own). This is part of the reason that the DART team has been set up; we are familiar with which services do what and so should be able to offer patients the local clinics that are relevant.

I hope that my reply has been of use to you and please be assured that we will be using the information to try and improve our service for future users. Thank you again for your feedback.

Best wishes,


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