GPs say lack of discharge data puts patients at risk

One in four GPs has seen patient safety put at risk in the past six months because hospitals have failed to provide adequate discharge summaries, according to the NHS Alliance.

The Alliance says the results of its third annual survey on patient discharge information were particularly disapppointing since a new NHS Standard Contract was introduced in April.

The contract, which does not apply to some foundation trusts and independent sector treatment centres on old contracts, requires hospitals to provide discharge information within 72 hours of a patient’s discharge.

“Six months on, we had hoped to see clear, even if limited, signs of improvement," says a report from the Alliance, which is holding its annual conference this week. 

"There was even the possibility that foundation trusts operating under existing contracts would be motivated to meet what is now obvious good practice. We were disappointed.”

The report says that even though more hospitals are providing electronic discharge summaries and that more are making an effort to ensure information is provided promptly, the same proportion of GPs continues to report that they experience late discharge information “very” or “fairly” often – a total of 72% in 2006, 70% (2007) and 71% (2008).

In 2007, one in five doctors said they had never had a case where patient safety had been compromised by late discharge information. In 2008, that number had almost halved to one in ten.

Dr Mike Dixon, chairman of the NHS Alliance, said hospitals should now not be paid until they have delivered prompt, accurate and complete discharge information.

He added: “This is a shocking indictment of current practice in secondary care. Hospitals seem not to understand nor care that ill patients still need treatment from their family doctor when they go home.”

Earlier this year, GPs called for better upake of electronic discharge summaries after another Alliance survey found that 70 per cent of practices experience severely delayed discharge summaries either very regularly or fairly regularly.

Problems highlighted by the most recent survey included discharge information arriving months or even years late, illeigble handwritten letters, summaries that fail to mention drug allergies or intolerances and letters that fail to give the patient’s name or any contact details at the hospital.

As well as withholding payments until discharge summaries are provided, the Alliance wants to see a new requirement on hospitals to include the full Payment by Results HRG coding and the costs that will be invoiced with the discharge letter.

The Alliance said that would ensure complete clarity and improve activity data at the same time.

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