"GP Referral to Specialist System"

About: Devon Access and Referral Team (DART) Royal Devon and Exeter NHS Foundation Trust

(as a relative),

My daughter (aged 15) saw her GP on at the very start of September. The GP said she would refer her to a specialist. On Saturday, my daughter received a letter from Devon Access and Referral Team (DART) asking her to phone for an appointment.

I phoned DART this morning and the person who answered said she had no available appointments at Royal Devon & Exeter Hospital but would refer my daughter to the hospital who would get in touch within 2 - 6 weeks.

I feel this referral system is just another example of how the NHS wastes valuable taxpayers resources. I think it is overly bureaucratic and totally non patient friendly.

Why at the time of the GP consultation can a letter not be printed off (similar to how they do prescriptions) given to the patient, with a website or phone no so that they get direct access to the specialist to make the appointment? As the appointment is made by the patient the risk of missed / cancelled appointments would reduce as the patient knows at the outset if the date available is convenient or not.

In my opinion, this would reduce considerably the amount of time wasted and reduce the amount of clerical staff required and the money saved could be used for patient care.

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

Dear ‘exasperated of devon’,

I would like to thank you for taking the time to let us know about your experience of using the DART service. We value the feedback we receive from patients and we do act on it wherever possible.

The solution that you have suggested is very similar to how our system is supposed to work. Patients are asked to call DART so that we can discuss with them which hospitals are available for them to choose from. We should have access to the appointment dates and time of each of the hospitals so that patients can take waiting time into account when making their choice.

Unfortunately, at times, various services become fully booked meaning we have no available appointments to offer to the patients/parents. In this case, all we can do is pass the patient’s information on to the hospital of their choice to be added to a waiting list, so that the hospital in question can contact the patient once they have set up more appointments.

As you have pointed out, patients are more likely to attend appointments when they have been able to choose the date and time themselves and it was with this in mind that the current system was set up. We are working very hard with the local hospitals to try and improve the situation so that, at all times, appointments will be available on the system for us to book. We are aware that it is not fair on the patient to have to ring us to make an appointment only to be told that they will have to wait for one in the post anyway. However, the situation changes on a daily basis, due to a combination of demand and availability, so it is impossible for us at DART to predict when services will have appointments or not and so all patients must phone here first. Had you phoned on a different day or wished to attend a different hospital, we may well have been able to book the appointment there and then.

The reason that the details for DART are posted to you by your surgery, rather than given to you during your GP consultation, is so that your surgery has time to type up and record the details of your referral and an appointment cannot be booked until this letter is written and attached to the system.

Please accept my apologies for the inconvenience and frustration caused and my assurance that we are doing all we can to improve the situation.

Kind regards,


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