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What to know about Hospital Discharge Summaries

Ensuring patient safety is a priority for all healthcare professionals. However, the patient journey is becoming increasingly complex, with a host of healthcare professionals now involved directly in their care. Multidisciplinary teams are adept at providing quality care and help improve health outcomes, whilst optimising the efficient use of resources at the same time. In order to seamlessly transition a patient from any provider of care, information and summary of care received must be relayed effectively. Hospital discharge summaries are what hospitals use to document and communicate with other care providers.

Each year NHS Digital provides information, data, and statistics relating to the NHS. The Hospital Admitted Patient Care Activity, 2017-2018, gives a snapshot of hospital admissions, a surge in the number of hospital admissions can be seen, with a 23.3% increase from 2007/8 to 2017/18. Such a staggering increase in the provision of care has to be coupled with effective modes of communication between the hospital and primary care. 

The 1843 fax machine still going?

Prior to the introduction of e-discharge summaries, the sharing of information was troublesome, to say the least. The National Audit Office estimates that delays with discharges to elderly patients are costing the NHS £820 million a year. As a result, it is estimated that over 2.7 million bed days are lost due to the unnecessarily delayed transfer of elderly patients from the hospital. Delays in discharge summaries being processed via fax machines, incomplete variants of discharge summaries, unstandardised templates, and illegible information are also a major issue creating difficulties for medicines reconciliation. Staff working in hospitals would attempt sending discharge summaries via fax machines numerous times, often to no avail as GP fax machines weren’t even switched on at the weekends. Hold-ups in patients receiving appropriate treatment can lead to potentially serious consequences, with patient safety and care compromised. The Clinical Data Standards Assurance programme began a national project to enhance discharge summaries and how they are accessed, with the goal of GPs receiving the discharge summary electronically within 24 hours of the patient being discharged from the hospital. 

What’s included in a Hospital Discharge Summary?

Discharge summaries include the following important pieces of information:

  • Reason for hospital admission
  • Results of any tests and any significant findings carried out during the time at the hospital
  • Procedures and treatment received during the hospital stay
  • Discharge details
  • Diagnoses
  • Legal and safeguarding issues
  • Changes to the medication regimen
  • Follow-up arrangements that have been made, including any therapy or dietary recommendations  
  • Details of person completing record with signature

The hospital discharge summary will be written by the doctor who was looking after your care during your admission in the hospital. An e-discharge summary template is provided here

You can request a copy of your discharge summary from the ward manager or request a copy from Patient Advice and Liaison Service (PALS). It’s always good to have a copy at hand, also making sure you are fully involved in your treatment and care. 

Who receives your discharge summary?

  • Your GP surgery receives a paper and electronic copy of your discharge summary
  • You get a paper copy at the time of discharge
  • A copy is placed in your hospital notes
  • Your nominated community pharmacy receives an electronic discharge summary allowing them to amend your medication regimen

NICE Guidance states that patients should be discharged from the hospital at the right time, to the right place and in the right way – whether that is to their own home or a community, or care home setting.

Why are discharge summaries important?

Discharge summaries are paramount in ensuring safe provision of care across the board in primary and secondary care. If completed correctly with the relevant information recorded, they assist your GP surgery and pharmacy of what has happened to you during your stay in hospital. In many instances, you are provided with either 7 days or 14 days’ worth of medication to take home, especially if there have been any changes to your medication. This gives you sufficient time to arrange with your surgery and pharmacy any medication requests that you may have.

Your doctor can then also change your prescriptions accordingly, chase any test results, and arrange any follow-ups where needed.

Check out our Services page, to see the many different ways that Firza is assisting GP practices, NHS CCG’s, care homes, and pharmacies in patient and non-patient facing ways, including the best ways in implementing effective hospital discharge summary reviews.  

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​This article was written on behalf of Firza by Hassan Riaz from Pharmacy Mentor