GPs asked to report patient harm after trust failed to send over 14k discharge letters

Exclusive A hospital trust has failed to send over 14,000 discharge letters to GPs due to ‘a failure’ in the process, Pulse has learnt.

University Hospitals of Leicester (UHL) told Pulse it discovered that 14,443 discharge letters were not digitally sent to GP practices between March 2023 and March 2024.  

The trust said that an audit of a ‘random selection’ of 120 patient records covering the period has been conducted to ‘check for any potential patient harm’.

GPs were not asked to go through the backlog but they were asked to contact the trust if they have ‘any concerns’ that patients have ‘come to harm as a result’ of the practice not receiving a hospital letter during the affected period.

GPs with concerns have been sent information on how to get in touch with the trust, UHL said.

This is the latest in a series of similar incidents uncovered by Pulse during the past two years, which led to chaos for GP practices having to deal with backlogs and to anxiety for patients whose clinical information could have been missed.

Leicester, Leicestershire and Rutland (LLR) LMC chief executive officer Dr Grant Ingrams said that the LMC and the trust agreed that the additional workload of having to check thousands of letters ‘would be disproportionate for practices’.

He said: ‘For example, it would not just be reconciliation of medication, but the practice would then need to look through every clinical interaction since the date of discharge (within and external to the practice) to check if there had been any subsequent changes.’

He said that the backlog ‘could cause some issues with patients’, mainly because the practice would not have received a final message to say why a patient had been in hospital.

On the trust auditing 120 patient records to check for harm, he said: ‘Even if you checked 99% of the letters, how do you know that the last letter didn’t include something which could have caused harm – but with that kind of audit you get a good idea, I think that gives you a reasonable idea.’

He told Pulse that the trust ‘found out what’s gone wrong and they have taken notice’.

He added: ‘They were willing to provide the candour and they said “we want you to tell us if there’s anything from it and we will deal with it”. If they hadn’t done that, it would have been a different thing.’

The trust’s deputy medical director Dr Gang Xu said: ‘All patients receive a physical discharge letter when they leave our hospitals for their own record as well as a copy to be given to their primary care teams.

‘To ensure robust communication, a digital copy is also sent to their primary care provider automatically. We recently identified that some digital discharge letters had not been sent to the patients’ GPs.

‘As soon as we became aware, we acted swiftly to assess the scale of the issue and prevent recurrence. The digital process has now been strengthened, and we are confident that discharge letters are now being reliably sent electronically to GPs.

‘An in-depth audit was carried out that confirmed no patient harm has occurred, and we are in the process of communicating with all GPs.’

A message from the trust to GPs said: ‘If you have any concerns that one of your patients has come to harm as a result of your practice not receiving a hospital letter during the period March 2023- March 2024, please raise a TCS concern via the usual route but please document Discharge Letter Backlog in the Theme of issue or concern section so that the team are able to identify these for patient safety team review.’

Last year, Pulse’s award-winning investigation into hospital failures to send letters to GPs found that trusts across the country have failed to deliver at least 724,000 patient letters to GPs, in several almost identical incidents.

GPs warned that the incidents meant that clinical information was not passed and acted on as a result, causing a threat to patient safety and ‘anxiety’ for patients, and some practices had to deal with the delayed letters, which substantially increased their workload.

Earlier this year the NHS safety investigation body found that hospitals’ failures to send patient information to GPs led to patient harm.

‘Vital information’ about diagnoses, medications and necessary follow-up care is ‘often delayed’, incomplete ‘or missed altogether’, leading to incidents of patient harm after hospital discharge, according to the Health Services Safety Investigation Body (HSSIB).