"Devon Access and Referral Team (DART)"

About: Devon Access and Referral Team (DART)

(as the patient),

I have had two increasingly farcical experiences with DART.

In the first I was being referred for an orthopaedic consultation. My GP told me that I would be given a choice of units and I asked him which was the better considered in his opinion. After hearing his personal opinion I asked to be referred to Exeter RD&E but still had to go through the rigmarole of waiting for a letter, phoning DART and finally getting an appointment. I cannot see what possible value this is adding? My knowledge of current orthopaedic consultants in the South West is understandably sparse so why can't I defer to my GP?

Secondly, I have asked my GP for referral for a vasectomy several weeks ago. He dutifully referred me and specified that I should see another Dr at the same practice who does minor surgeries, presumably at the local hospital. Despite this seemingly simple setup the referral process still has to go through DART... Upon phoning DART I had to go through the usual process although notably I was not asked for my password.

After a few minutes I was told that I had come through to the wrong "side" and would I hold. After holding I had to give all the same details again, still with the password omitted (incidentally, I'm fairly sure that this was the exact same password I had 6 months ago for my knee). The operative then informed me that the Dr to whom I had been referred had no open appointments so would I like them to get the referral re-issued from my GP or go on a waiting list. I opted for the latter and waited a couple of weeks to receive a my appointment. With a different Dr. at a different Hospital.

This was followed a week after that by two further letters, the first informing me that there had been a mistake and my appointment had been cancelled and the second giving me details of my new appointment. With the same Dr. At the same Hospital. 8 weeks after the first.

Bear in mind that this is just for the counselling to make sure I really do want a vasectomy, the actual procedure will have to be booked afterwards. I seriously do not care who I get or where they work, as long as they have a white coat and warm hands I'm sold.

I do not understand how this benefits the patient nor who was asking for this in the first place. If it really has to be done can it please be done better?

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

Dear ‘tommyg’,

Thank you for getting in touch and letting us know about your experience. It’s very useful for us to know how the service is experienced from the patient’s point of view so that we can try to improve our processes and I’m very sorry that you felt both of your experiences with DART were unsatisfactory.

The DART service has been set up with the aim of ensuring that patient’s are given a choice of hospitals to be treated at and, where possible, a choice of date and time for their appointment. The standard process for all GP surgeries in the area is to send their referrals to DART so that we can do this. If your GP wants you to be seen by a particular specialist or at a particular hospital, perhaps for medical reasons or because of your preference, then they can address the letter accordingly and we will follow those instructions. Having said that, when the patient phones in we can advise if the wait is particularly long for that specialist or hospital and patients can then opt to change their preference in order to be seen quicker elsewhere.

Regarding your referral for a vasectomy, it is standard practice throughout the area for patients to be offered counselling before going forward for the procedure to make sure that the patient is prepared and this is not something that we are able to by-pass. Without being able to look at your particular details I cannot be sure but I suspect that the reason your appointment is not with the doctor that your GP specified is that the person doing the counselling and the person doing the procedure will be different so it could well be the case that your appointment for the vasectomy itself will be with the doctor that your GP recommended. If you would like me to look into this further, please feel free to call me on 01626 883888 and I will investigate the matter for you.

I am unable to comment on the reason for your appointment being cancelled and put back as this will have been a decision taken by the hospital in question but I’m sure that the hospital regret having to do this and would wish to pass on their apologies.

With regard to your password, it will have been the same as the one you had before as your password on Choose & Book remains the same for all your referrals.

We are very committed at DART to improving the service for patients so I’d like to thank you again for bringing these issues to our attention and I hope that this message has gone some way to explaining the way we work and why.

Kind regards,


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