Discharge letter targets will create two-tier care

The NHS Alliance claims government targets for discharge letters will create a two tier system on a critical patient safety issue because the obligation will not apply to most foundation trusts.

The organisation, which represents PCTs and GP practices, has been campaigning to improve the timeliness and quality of discharge summaries and last year called for better uptake of electronic discharge summaries.

The Department of Health’s Operating Framework for 2008/2009 includes new obligations on acute trusts to deliver discharge summaries more promptly from April 1 2008 with summaries to be delivered within 72 hours up to March 2009, within 48 hours between April 2009 and March 2010 and within 24 hours after April 1 2010.

However the NHS Alliance says the obligations will not apply to most foundation trusts as those with existing three year contracts will not have to meet the targets until their current contract runs out.

Dr Mike Dixon, chairman of the NHS Alliance and a GP in Collumpton, Devon, said discharge summaries were as much a part of patient care as a surgical procedure or diagnostic test.

He added: “It is unacceptable – and potentially dangerous – to fail to ensure that all patients receive the same standard of care.

“It is impossible for GPs to treat patients properly when they do not know the results of diagnostic tests, what treatment has been given in hospital or what medication has been prescribed. Yet we are in danger of accepting a two-tier system. Foundation Trusts, meant to be the best, can avoid meeting the most up to date standards in providing essential discharge information.”

A survey of 650 practices conducted by the NHS Alliance last year found that that 70 per cent of practices experience severely delayed discharge summaries either very regularly or fairly regularly. The Alliance said IT would be a better and quicker way of delievering discharge summaries in future.

Fiona Bar

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