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GPs need faster and better quality discharge information, inspectors say

Significant improvement is needed on the quality and speed of discharge information provided to GPs in Wales, a report from the Healthcare Inspectorate has concluded.

A review found wide variation in how discharge information was shared as well as whether targets for sending information was adhered to.

While electronic systems were working well in some areas, others were still relying on fax to get information to GPs, the report found.

The review on quality of discharge information was carried out after concerns were identified during routine inspections of GP practices.

A recurring theme had been found around a lack of accurate and useful discharge information, delays and poor quality transfer of information as well as incomplete processes.

The subsequent review found a lack of understanding of what information should be shared between secondary care and GPs and a failure amongst professionals to take responsibility for effective communication which could put patients at risk.

And while some areas were making progress, this is far too variable across Wales, the Inspectorate said.

Overall there were 13 recommendations including that NHS Wales set a target date for all discharge summaries and clinical letters to be sent to GPs electronically.

And it said healthcare organisations should ensure they have mechanisms in place to address problems at the primary/secondary care interface.

Dr Kate Chamberlain, chief executive of Healthcare Inspectorate Wales said: ‘Our review recognises the commitment of staff to improve management of patient discharge, with some examples seen of good practice being developed across Wales.

‘However, the overall picture is variable with a fragmented approach being taken across Wales and local initiatives and tools being developed in the absence of national solutions being implemented.’

Dr Martin O’Donnell, RCGP Wales vice-cChair, said patient discharge arrangements are common source of frustration for patients and for GPs as well.

‘When a patient leaves hospital GPs need to have the right type of information, particularly around medication and any significant developments during the stay. Often this isn’t the case.

‘Information also needs to be transferred in the right way; it shouldn’t be a surprise that electronic discharge delivers improved outcomes. It’s further evidence of the NHS being held back because of a lack of IT and technology.’

A Welsh Government spokesperson said: ‘The report recognises electronic discharge has had a positive effect in Wales. The Medicines Transcribing and e-Discharge (MTeD) system is currently being rolled out to all hospitals in Wales, providing GPs with immediate access to high quality electronic discharge information.

‘We are also increasingly sharing this information with patients’ nominated community pharmacists to ensure that any changes to medicines made in hospital are continued in the community. We are also commissioning a review of ICT infrastructure in NHS Wales. We will consider the findings of the report.’