CQC criticises discharge summaries

The Care Quality Commission has warned that the NHS may be failing to prevent harm to patients by failing to share information when they move between services.

The findings come in a report by the watchdog called ‘Managing patients’ medicines after discharge from hospital’, based on a national study that visited 12 primary care trusts and surveyed 280 of their GP practices.

Eight out of ten (81%) of the practices surveyed said that when hospitals sent them discharge summaries details of medicines were incomplete or inaccurate “all of the time” or “most of the time.”

The study also found that: “Information shared between GPs and hospitals when a patient moves between services is often patchy, incomplete and not shared quickly enough.”

Only 53% of GPs said that summaries were received in time to be useful for a patient’s first follow-up GP appointment.

Cynthia Bower, chief executive of the CQC, said: “It is important that basic systems to share essential patient details are working effectively to get the right information to clinicians at the right time to minimise risks.

“It is clear from this study that services have some way to go before this routinely happens in the way it should.”

In April 2008, a new national standard was introduced to make sure that acute hospitals send discharge summaries to GPs within 24 hours by April 2010.

The deadline means that most trusts will need to send discharge summaries electronically. Failure to meet the deadline could incur financial penalties.

In its report, the CQC endorses the electronic exchange of information: “The CQC advocates the roll-out of an IT system suitable for sharing information in a more effective way.”

Bower said: “People have a right to expect clinicians to know details about each stage of their care, and in this day and age they are right to do so.

“There needs to be a change of attitude in the NHS in recognising how important it is for clinicians to pass the baton smoothly between services in order to offer person-centred, integrated care.”

The report also criticises the NHS for allowing non-clinical staff to update GP records. In 17% of the GP practices surveyed, patients’ notes were updated by managerial or clerical staff.

Although doctors checked cases, the CQC says there is not enough evidence to assess the extent or quality of this oversight.

In two thirds of the PCTs visited, there were no systems in place for monitoring whether discharge summaries were reviewed and patient notes updated effectively within practices.

The study also found problems with the information provided to hospitals by GPs. Ninety eight per cent of GP practices claimed that they provided hospitals with a list of all medicines currently prescribed to patients in non-emergency cases.

However, analysis showed that a quarter were not providing information on previous drug reactions, that 14% did not provide information on co-morbidities and that 11% did not mention known allergies.

Link: Managing patients’ medicines after discharge from hospital