Page last updated at 09:50 GMT, Thursday, 16 October 2008 10:50 UK

Home-bound patients 'put at risk'

Stethoscope
GPs say patients are being put at risk

Patients leaving hospital face danger because vital messages on their care are either inaccurate, or never sent at all, say GPs.

A recent NHS-wide contract was supposed to improve hospital discharge details.

However, two-fifths of GPs surveyed by the NHS Alliance said they had seen a patient put at risk because of missing letters or mistakes.

One patient was given a disposable sick bowl inscribed with the name of drug their GP was supposed to be prescribe.

Hospitals should not be paid until they have delivered prompt, accurate and complete discharge information - and if that is late, then there should be a financial penalty
Dr Michael Dixon
NHS Alliance

The NHS Alliance, which represents GPs, surveyed hundreds of GP practices about the quality of "discharge summaries" they received from their local hospitals.

A good summary, sent directly to the GP, should have details of why the patient was in hospital, any operations or treatments they had received, and details of any drugs or further treatments they might need in the community.

Unfortunately, the poll revealed many instances where this did not happen.

In one case, a patient being treated by her GP for clinical depression was admitted to hospital following an overdose.

The GP did not receive any information about her attempted suicide for 11 months, and as a result had not reviewed or changed her medication to reduce the risk of further attempts.

In another example, the discharge letter arrived on the GP's desk seven weeks after discharge, and six weeks after the death of the patient.

Shortly afterwards, the hospital sent another letter about the same patient, but containing completely different clinical information.

GPs complained that many discharge summaries were illegible, did not mention drug allergies or intolerances detected in hospital, or did not even give the patient's name, or any contact details at the hospital for further questions.

Quick deal

The NHS has been trying to tackle the issue, and in April introduced a "Standard Contract" which required hospitals to provide discharge information within 72 hours of a patient leaving hospital.

One in four GPs surveyed said even since that date, poor discharge information had placed patients at risk.

In total, 42% said it had happened in the past three years, and almost half said that the problem had compromised their care.

Just over a third said the contract had made a difference.

NHS Alliance Chairman Dr Michael Dixon said: "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.

"Hospitals should not be paid until they have delivered prompt, accurate and complete discharge information - and if that is late, then there should be a financial penalty."

A Department of Health spokesman said: "Patients should receive the best level of care possible within the NHS.

"It is unacceptable for patient safety to be compromised due to lapses in communication after a patient has been discharged from hospital."


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