Dishonourable Discharge

The GP magazine Pulse reported on Friday 18th November that ‘GPs raise alarm over hospital discharge letter delays’.

I am sure pharmacists would concur with that. It was estimated that up to 40% of hospital discharge notes never reach GPs. This may be due to the postman, hospital admin staff, those crazy GP receptionists who are too busy making clinical interventions (see ‘Can I take your order please’ post) or other factors.

Sometimes the hospital will give a weeks supply of medicines. This may be enough time to sort out a new prescription from the GP but generally it is not. Patients come to us to ask us to order their new medicines straight after discharge and we have to explain that we are not able to order it as the surgery will just ignore the request as the patient has not had it before.

It would be helpful if pharmacists got sent a copy of the discharge letter too with patients consent. This would act as a back up and keep us in the loop. On more than one occasion, I have to fax a copy of the patients discharge copy to the surgery as they had not got one.

6 thoughts on “Dishonourable Discharge

  1. Nicely put, I do think the communication between hospital and community could be alot smoother, and i dont think it would really take much, just a template or a procedure which like you said put pharmacists and GPs in the loop of any change in medication by the touch of a button… we are in the 21st century.. arent we? šŸ™‚

  2. That’s very true. The amount of times I have had to chase up new prescriptions from surgeries after patient’s have been discharged is unbelieveable.

    On more than one occasion the surgery had a copy of the discharge sheet but still issued the old repeat medication on prescription. Just as well I was able to intervene as I luckily had a copy of the discharge sheet too.

    Its not always the hospitals we should be pointing the finger at! However, I do agree that there should be an improvement on the communication between the sectors.

  3. Yes, you’d think this would be common sense. Today I found out that a patient had her Amlodipine stopped. I found out from the patient, not the surgery. All it would have taken is a post-it on the Rx. And it would have saved us chasing the ‘missing’ item up.

  4. It comes back to some old chestnuts about a) patients not being registered with/users of a single pharmacy, b) the GP being “custodian” of the patient’s entire health record and c) Hospitals threatened with having business-ending financial penalties for so many things, there’s little time or energy for common sense.

    All of which are solvable, but all are still challenging.

  5. I agree with you. !!
    It becomes so difficult to handle when patient is there asking for ordering and you can’t deny help! If nurses responsible fOr discharging patients could just fax a copy each to pharmacy and surgery can not only speed up process but keeps the continuity of care for a patient who might be just coming out of hospital after a survey or therapy. Unnecessary delays prolong the end pout of getting care and drugs to patients.
    If the discharge notices are made electronically, they can be sent electronically with one touch to patient’s GP and pharmacy. When making records of patients, Hospitals do put all details on patients record on computer (i have seen records) so Electronic fax setup, secured by login (to prevent un-authorised faxes) That’s so easy !! …..

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