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Hospital fined for failing to send discharge summaries on time

A CCG has withdrawn £60,000 of funding from its local trust because of its poor record in sending discharge summaries to GP practices.

North East Essex CCG imposed the penalty when Colchester General Hospital failed to hit its target of sending 98% of discharge summaries to a GP practice within 24 hours of a discharge, managing only 80.4% in September, 83% in June and 92.5% in April.

This follows the hospital being placed under ‘special measures’ earlier this month by NHS watchdog Monitor, after the CQC said staff were ‘bullied’ into altering cancer statistics to hit national performance targets.

Dr Brian Balmer, chief executive of North and South Essex LMC, backed the move.

He said: ‘The CCG is quite right to withdraw the funding. As a GP that is what would happen to me if I stopped providing certain services. Now that there is more GP influence on commissioning the providers are being told that integration with hospitals must happen and the services must improve.’

Dr Balmer warned that there can be dangers for patients if GPs do not receive discharge summaries, because these documents can describe important changes in medication that need to be implemented.

He added: ‘Delays can damage the relationship between a patient and a GP. The patient is told by the hospital that the summary has been sent and then goes to the GP to find out it hasn’t been received. They can think that the GP is an idiot for not knowing anything about it. Delays can also mean that the GP has to chase round to find out what’s happened to the discharge summaries.’

A North East Essex CCG spokesperson said: ‘We understand some of the reasons why the hospital has failed to meet the need for timely summaries to go out to GPs.  Nonetheless we are obliged to enforce the penalty as a matter of patient safety.’

Colchester Hospital said it had an ‘action plan’ in place to improve its record on discharge summaries. Part of the problem is that an electronic system for sending summaries has not been fully operational, the spokesperson said.

Readers' comments (8)

  • I fail to see their problem. Every instant technology to hand and yet somehow they get it wrong. May they continue to be fined. Very slap-dash. No excuse.f

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  • I sometimes get really crap referral letter from GPs with either no useful information or inaccurate information. Please may I levy a fine?

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  • You can try but you might find that difficult.

    You see, there is this thing called contract which defines your responsibilities for the money you are getting (called tariff, just in case you're not heard about it). And one of the nationally (that means all across the country) set agreement is sending discharge within 24 hours. You see, in grown up world, failing to meet an agreement can result in punishment.

    Hope I didn't make the explanation too complicated for you. Run along now, you have a nice day.

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  • "I sometimes get really crap referral letter from GPs with either no useful information or inaccurate information. Please may I levy a fine?"

    If it's specified in the contract then then yes, you can levy a fine.

    Alternatively, if you don't like the referrals and they are not acceptable to you (or your hospital's management), you could always choose not to enter into a contract at all and let someone else do the work.

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  • Peter Swinyard

    OK - grown up discussion time. I assume the "really crap referrals" referred to are comments by hospital doctors. Perhaps a polite phone call to the relevant GPs asking for a little more information may be helpful? There are also mechanisms for supporting poorly performing GPs and helping them improve - but not by throwing insults around.
    In Swindon area, our shadow CCG dealt with the delayed letter problem by helping the PCT to enforce the contracted service standards - we now get very timely and helpful information and are able to work together with our hospital colleagues to the benefit of patients rather than going to war or slinging insults around.

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  • You're lucky if they get sent to the right practice so maybe better late than never?!

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  • OK, I'm a hospital doctor, but I agree that it is unprofessional and even dangerous not to inform GPs promptly about the hospital care of their patients. But £60,000? Really? What difference is that going to amke in a £200m annual budget? If the hospital is f'd up that it is in special measures that kind of fine has to be in the "Yeah, whatever" category for hospital management.

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  • I suspect the CCG concerned, if it too is bailing out secondary care like the CCG in my area, they are simply trying to make a point, Millions is being transferred from primary care budget to bail out the hospital in my neck of the woods - so if happening elsewehere, this might be the reason. This is what the politicians want - fighting between primary and secondary care. Don't give it to them - let's all be adult about it and work for the good of the patient. An odd idea, I know.

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