"I was seeking an appointment to see a specialist in PMR"

About: Care Opinion Devon Access and Referral Team (DART)

(as the patient),

I see that DART’s claim is: "… to offer patients a choice of time and place for their treatment, wherever possible, and to provide information that patients may require before they make their choice. The service has been designed, and is overseen by, local GPs who feel that this service is the best way for patients to make their appointments." Well -

1 - I rang DART on receipt of their letter (unsigned and undated) – and was puzzled that it didn't come directly from the hospital department concerned. Why does a third/fourth[?] party have to be involved?

2 - This was a slow response by DART - some twelve days since my seeing the GP.

3 - DART couldn't offer me an appointment until 24th July... Eight weeks' time. What is the point of such a delay? Who does it help? And how do I cope in the meantime? If DART is to function effectively it must offer early appointments with a minimum of delay.

4 - The DART member of staff - no name given - suggested there might be an earlier cancellation which I might wish to use. But I must ring the DART office (hourly? daily? weekly? how often?) to find out. There was no offer to ring me back. Would it not be more sensible and efficient for all concerned if DART rang me on the availability arising of an earlier appointment?

5 - Why doesn’t the rheumatologist’s secretary or similar write to or ring me directly? It would avoid all this cumbersome process of correspondence and codes and going through other bodies who are distant. My earlier appointments at RD&E have not been handled in this complex way before.

6 - I was offered, in the course of the conversation, a choice of three hospitals – but then told that two of them had no appointments available! What was the point of that? It’s not choice – which I wasn’t bothered about anyway - is it?.

7 - And why must I tell my ‘story’ to someone other than the DART member of staff who spoke to me?

8 - And why must it be published online? It doesn’t concern anyone else.

9 - One prompt response has been from the RD&E. I gratefully received their letter (unsigned) this morning. Although addressing it to me as Mr, the letter begins ‘Dear Sir or Madam’! And my time is shown as 14.30pm! No – it’s either 14.30hrs or 2.30pm, svp!

10 - Doesn’t all this feedback generate more complaints than would otherwise arise?

11 - What are the improvements, for the patients, that have been brought about ?

12 - My caller from DART was pleasantly spoken and capable, but I felt I was merely another UBRN in her day’s work.

13 - Not too much indication in my ‘story’ of DART being the best way for a patient to make his/her appointment, eh?

14 - So, I’ve told you my story. How will it ‘make a difference.?

• And regarding this questionnaire –

- It is so frustrating to use, partly because it is not possible to return to an earlier page to amend the text.

- The questions should all be on one continuous page, thus enabling the contributor to scroll up and down until the text is ready to be submitted.

- There is an absurd limit of a mere fifty characters on later questions! What is the point of that? That’s probably about ten words only! And I didn’t discover the limit imposed until after I had more fully responded to the questions.

- It does not allow the use of bold or italic text (for emphasis, say), or highlighting.

- I made two earlier attempts to complete the questionnaire, being baffled and frustrated by turns, which took over half an hour, only to find it telling me my email address or password was incorrect when I clicked to send it on its way!

- What does the question ‘What tests, conditions or treatments are in your story?’ seek to find out? If they’re relevant and in the story, you’ll know on reading it!

- I don’t see any sign of an Edit key…

- How much does all this procedure cost? And who finances it?

Do you have a similar story to tell? Tell your story & make a difference ››


Response from James Munro, Chief executive, Care Opinion We are preparing to make a change

picture of James Munro

Dear Fraxinus excelsior

Many thanks for your feedback and questions. As one of the Patient Opinion team I'm able to respond to the questions you raise about Patient Opinion itself. I expect that Dart will respond to your feedback about their service.

In terms of Patient Opinion itself, we are a non-profit social enterprise. Our aim is to make it safe and easy for people to give feedback about the health services they use, so that others can use that feedback to help make services better. The "others" who use the feedback we publish include NHS organisations providing care (such as Dart), as well as NHS commissioners (who hold budgets), regulators such as CQC, policymakers, individual clinicians, educators and researchers.

Because the feedback people such as yourself contribute is both public and online, it is both cheap and easy for large numbers of people to use the feedback, for many different purposes, at very low cost.

You can see the changes that Dart has made in response to feedback simply by visiting the Dart page on Patient Opinion (click the Dart link just above your name on your story) and then selecting the "Latest changes" tab.

You ask about complaints. The limited evidence we have on this question suggests that Patient Opinion may reduce subsequent complaints to the NHS, but whether this happens depends on the quality of the response posted online.

I'm really sorry you had a frustrating time posting your story in the first place, and I'm grateful for your suggestions for how we could improve our system. We're always looking for ways to make Patient Opinion easier to use, and as the person responsible for our technical side I'll review your suggestions personally.

Incidentally, there is an Edit button at top right of every step on the "Tell Your Story" page.

Feel free to respond to this if you have further questions or concerns.

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Response from Gemma Smith, Project Support Manager, DART, NHS Devon

‘Dear ‘Franxinus excelsior’,

Thank you very much for getting in touch to let us know about your experience of using the DART service. 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’m sorry that you are unhappy with the service you have received.

Regarding the time it took for you to receive DART’s contact details for your referral, and the content of the letter, this is sent by 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 in receiving the letter informing you to contact DART. If you feel that this is not the case, please let us know, by reply to this post or by phone, which surgery you are registered with, and we will ensure that the practice are made aware of your feedback.

Patients are asked to call DART so that we can offer a choice of all the hospitals available. We have access to the appointment dates and time of each of the hospitals and can advise on waiting times to help with making a choice. At the time the patient calls we will always offer them the earliest available appointments. If your appointment was not as early as you had hoped we apologise for this but we are only able to offer the appointments that the hospitals have available and sometimes services do become very busy. Although cancellations do occasionally free up earlier appointments, this is quite infrequent and we would not recommend that patients ring back as a matter of course, so please accept my apologies if you were given this impression. If you have any concerns about your health whilst waiting to be seen at the hospital, you are advised to contact your GP who is still responsible for your care in this interim period.

We have signed up to use the Patient Opinion service as one of the ways patients can express their opinions about the service we provide. Due to the nature of Patient Opinion, any comments are accessible online and we accept that this is not everyone’s cup of tea, therefore you are still more than welcome to speak to a manager directly or write to us directly. I can only apologise if you were not given this as another more suitable option for you.

I am pleased to hear that your letter from the RD&E arrived promptly and will pass on your comments about the formatting of the letter which I agree does not sound correct. We do meet regularly with local hospitals and all feedback such as yours is discussed. Although I cannot promise to make any changes in hospital processes I can assure you that we do share patient feedback with them and RD&E are themselves now using Patient Opinion as a means of learning how well their processes are working. Our experience of using Patient Opinion has been a positive one and this has added a level of transparency to the way we work and communicate with patients based on comments we receive. All opinions are valued and we have certainly changed some of our processes as a result of feedback from patients.

Please feel free to respond to my reply if you have any further queries.

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