Hawking calls for action on A&E info

A GP is to report her concerns about the IT used to generate reports for GPs on accident and emergency attendances to the National Patient Safety Agency.

Dr Mary Hawking, a GP in Dunstable and member of the British Computer Society’s Primary Healthcare Specialist Group, says the reports are unfit for purpose and constitute a patient safety risk.

She is investigating GPs’ experiences of A&E reports after becoming concerned about the reports her own practice receives from hospitals and is keen to hear from others about their own experiences.

She told EHI Primary Care: “So far I haven’t been able to find anyone happy with the reports they receive.”

Dr Hawking said most reports appeared to be generated on standalone systems and contained only very brief transactional information.

This might include data on time of attendance, a brief description of the presenting complaint, possibly some information on management – such as ‘verbal advice’ – and possibly a diagnosis using an ICD-10 term.

She added: “There is also occasionally line of text which says investigations ordered with the message that unless stated otherwise they are normal which we have found is not always the case.”

Dr Hawking said the information provided to GPs by such reports was inadequate.

She added: “With that amount of data you have no way of knowing what is going on. I think it’s probably an IT problem as the reason for doing these reports is to produce statistics or numbers attending and so on but it is clinically dangerous.”

Her practice now plans to run a small preliminary survey, sending patients a copy of their A&E report asking what actually happened and checking on their knowledge of alternatives to an A&E attendance.

Dr Hawking said A&E attendance reports for GPs should include more information on history, examination and investigations including which investigations had been ordered and the results plus more information on diagnosis, treatment and follow-up.

GPs this year are being incentivised to look at A&E attendances as part of Quality and Productivity (QP) indicators aimed at reducing inappropriate use of A&E.

Dr Hawking said this was made much more difficult by the quality of information received and that inaccuracies made analysing the information futile.

But she added: “QP12 is a minor matter – I’m concerned that the IT being used in A&E reports – the only information received by GPs – is not fit for purpose and constitutes a patient safety risk. It has been going on for so long that we have just given up and accepted it.”

Dr Hawking’s concerns were backed up by Dr Chaand Nagpaul, deputy chairman of the BMA’s General Practitioner Committee and its lead on IT issues.

He told EHI Primary Care that there is no standardisation of information provided to GPs from A&E departments which varied from hand-written to brief electronic information.

He added: “It also sometimes comes to us weeks later which is a clinical governance concern as well. It is a matter of some considerable concern. I hope the QP indicators this year will highlight the problems there are with this data.”