The NHS Alliance's third annual survey of NHS patient discharge information found problems persist with accuracy and, crucially, timeliness. Since 1st April this year – in just six months – one in four GPs has seen the safety of a patient put at risk because hospitals have failed to provide essential information when the patient was discharged.

More, four out of ten, say the clinical care of their patients has been adversely affected. The findings come after a new NHS Standard Contract was introduced, requiring hospitals to provide discharge information within 72 hours of every patient’s discharge.

Doctors told the survey about discharge information arriving months or even years late. In one case, a discharge letter arrived seven weeks after discharge – and six weeks after the patient had died. Then another letter arrived, about the same patient and the same admission, but with completely different clinical information. There are illegible handwritten letters, discharge summaries that fail to mention drug allergies or intolerances – potentially very serious – and letters that fail to give the patient’s name, any contact details at the hospital, or which are sent to the wrong GP and the wrong practice.

It is common for patients to be told to go to their GP for a prescription even though the hospital had sent no information about what medication was recommended, nor the test results and diagnosis. One junior hospital doctor did do his best though. He scrawled the name of the medication on the bottom of a disposable sick bowl with the note: “Ask GP to prescribe this”.

NHS Alliance chairman Dr Michael Dixon said, “this is a shocking indictment of current practice in secondary care. Hospitals seem not to understand nor care that ill patients still need treatment from their family doctor when they go home.

“We have been campaigning to improve discharge information for the past three years. It was our work that led to the new requirement for prompt summaries in the Standard Contract. That wasn’t a perfect solution – many Foundation Trusts and independent treatment centres are still operating under older contracts, so are not covered. All the same, it should have been an important step in the right direction.

“The answer is straightforward. Hospitals should not be paid until they have delivered prompt, accurate and complete discharge information. And if that is late, then there should be a financial penalty.”

Dr Brian Fisher, PPI lead of NHS Alliance said, "it's a real problem, which varies enormously from patch to patch. Whe the discharge summaries get delayed, it's dangerous, and can cause mistakes in prescribing and in many aspects of patient care.

"The obvious approach to improving this would be to set a target people must meet. We are lucky where I practice, that patients come out of Lewisham Hospital with printed discharge summaries, and bring it to their GPs. The process seems integrated into Lewisham Hospital discharge programme and it's very efficient. I don.t know why they manage it and others can't".