Headlines: March 29th, 2007



The safety of some NHS patients is being put at risk because of delays by hospitals in sending essential information to GPs when those patients are discharged, according to a survey published today by the NHS Alliance. More than a third of doctors it questioned said the delays affected patient safety and almost 60 per cent said the clinical care of patients had been compromised.

The study also found that doctors were unhappy not just because they were receiving information late but that there was also a problem with inadequate detail. They reported that sometimes a patient’s name could be missing from the hospital discharge summary, as well as the diagnosis, treatment, medication and contact details. In one case, a discharge summary was sent to the GP but it failed to inform him the patient had just spent a week in intensive care after suffering a stroke and a heart attack.

The Alliance’s report, ‘A very present danger’ , is calling for the Payment by Results system to be changed so no payments are made to a hospital unless it provides timely and accurate discharge information to the patient’s GP or primary care team. The Alliance, though, does not believe there are insurmountable obstacles. Some hospitals, or departments within them, were giving good prompt information and while seven out of 10 GPs had experienced late information “very often” or “fairly often”, 63 per cent said some acute providers did make sure they delivered good discharge information.

Dr Michael Dixon, the NHS Alliance chairman, said, “This widespread problem reveals an institutionalised, though unconscious, contempt for primary care and for the patient in primary care too. It demonstrates the current weakness of commissioner-provider relations.” He named the Heart of Birmingham and Worcester primary care trusts as among those taking effective action but said there needed to be changes at a national level so commissioners were able to determine what services they expected. “That may already be the case in theory. Too often, it is not so in practice. The answer is to make sure payments to all providers depend on their delivering what is required, including timely accurate discharge information to a minimum standard,” he added.

That view was supported by Dr Vijay Bathla, chair of the Heart of Birmingham PCT PEC, who said hospitals should be forced to comply with a set of minimum standards. There was no reason why they could not provide what was needed and this was essential to patient care. The report has been sent to the NHS chief executive David Nicholson.