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97% of discharge letters 'sent back late', audit finds

By Gareth Iacobucci

GPs have called for hospital trusts to be financially punished after uncovering evidence that more than 97% of outpatient discharge letters are not being sent back to primary care within the required 48-hour time period.

The findings have been unearthed after GPs in Swindon carried out an extensive audit into letters arriving at their practice from local hospitals, which found that their trust was in breach of its contractual obligations to send letters out within two days.

GPs claim the results of the audit, which was carried out to investigate the reasons behind high numbers of wasted appointments, demonstrate the need for urgent action, particularly given that hospitals will be contractually required to deliver outpatient letters in just 24 hours from 1 April 2010.

As a result, they are calling for contractual remedy to be sought for this year wherever possible, and that ‘contract levers be incorporated into next year's contract to promote compliance with the standard'.

GPs have also demanded that ‘non-compliance next year should be matched by withholding payment for a service which does not deliver against contract standards'.

Dr Peter Crouch, a GP at the Taw Hill Medical Centre in Swindon, which carried out the audit, urged PCTs to impose financial sanctions on acute trusts who breach their contract.

He said: ‘Our local trust breached those national contract standards in about 97% of cases. We were staggered by the size of it. If this is common across all trusts, then surely something ought to be done.'

Dr Crouch said he suspected the problem was being caused by a shortage of secretarial staff in hospitals, which was leading to a backlog in transcriptions.

He said: ‘Most consultants have no idea it takes that long for the letters to reach us. It sits in a queue, waiting for some poor secretary who's probably had all of her colleagues culled to get to it.'

A spokesman at the Great Western Hospitals NHS Foundation Trust said: ‘The results of the audit provide a useful insight into the way the GWH is corresponding with GPs in one local practice. We are working together with NHS Swindon to use the results to see how processes can be improved and discussions are already underway.'

The audit found almost 98% of outpatient discharge letters are not being sent back to GPs within the required 48-hour period The audit found almost 98% of outpatient discharge letters are not being sent back to GPs within the required 48-hour period

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