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Independents' Day

Dr Ivan Camphor: We have long been trying to raise the issue of poor communication at patient handover

Mid-mersey LMC medical secretary Dr Ivan Camphor explains why it’s important that NHS England has issued a Patient Safety Alert recognising the risks posed by poor communication when patients are discharged from secondary care.

We have long been trying to raise this as a cause for concern, and trying to address the problem of poor patient summaries.

Anything that raises this and brings it to the fore, such as the patient safety alert issued by NHS England, is very welcome and certainly positive. So I’m glad that NHS England is engaging this process and wish to improve things.

I was part of an audit of discharge summaries in the Wirral which certainly opened up a dialogue, and gave people a very clear understanding of what we required in primary care, how that information was being processed, and why we required that information.

It certainly helped give secondary care some perspective of the demands GPs are working under, in the form of QOF, enhanced services, disease management. It also highlighted to secondary care that the things they were doing, sometimes weren’t coded correctly.

A lot of the A&E discharges did not fully code the work done in A&E; for example if they had aspiration, or an injection, incision or a stitching, it often didn’t include that.

Similarly discharges from the ward weren’t coded correctly for whether they’d had an MRI scan, or more than one procedure done. Where more than one procedure was done, they were only coding for one.

So good communication really goes to the heart of it, because, by improving communication between primary and secondary care physicians, it takes away some of the silo mentality we’ve lived with for years.

It creates more integration, more harmony, but also improves communication and understanding of where your opposite clinicians are coming from – which is often lost in the system.

Dr Camphor is medical secretary at Mid-mersey LMC, and a GP in the Wirral.

Readers' comments (2)

  • I find the same problem of inadequate transfer letter when patients move from one hospital (or trust) to another exposing patients to unnecessary risk.
    This is exacerbated by lack of junior doctor support, lack of ownership and continuity of care.

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  • The most dangerous part is medication discharge mistakes and to get to the bottom of them involves telephone calls to ward clerks and nurses, secretaries and hospital doctors-nightmare

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