The Sentinel

REDESIGNED HOSPITAL LETTERS WILL NOW ‘HIT GPS IN THE FACE’

The changes come after coroner called in over death of patient

- Phil Corrigan philip.corrigan@reachplc.com

HOSPITAL letters to GPS are being redesigned due to concerns that vital instructio­ns may be overlooked – with potentiall­y fatal consequenc­es.

University Hospitals of North Midlands is changing the way it writes outpatient letters so that actions required by GP practices – such as changes in medication – can be more clearly seen and understood.

The change is being made in response to a Preventing Future Deaths report sent to the trust by a coroner. These reports are written following inquests into healthcare­related deaths, where the coroner believes actions can be taken to prevent deaths happening in future.

Professor Andy Hassell, chair of UHNM’S quality governance committee, told a trust board meeting that ‘we have to be extremely clear with our layout in communicat­ions to GPS, where an action is required by the practice’. He also said that UHNM had already changed its practice of addressing outpatient letters to patients with GPS being copied in – the reverse of what has been done in the past.

The specific case which prompted the Preventing Future Deaths report was not mentioned during the meeting, but it involved a change in medication. Non-executive director Arvinda Gohil, who also sits on the quality governance committee, said he had been ‘horrified’ to learn that some GPS ‘don’t really take outpatient letters that seriously’.

She added: “Related to this, there will be members of the community who do not have English as their first language. If they get a letter, they might not necessaril­y pick up the seriousnes­s of the issues.”

But Professor Hassell said it was not that GPS were not taking the letters seriously, but that they would often be read in the first instance by nonmedical staff.

He said: “The issue is that a lot of practices have a system of triage, often done by an administra­tive person. This is about collaborat­ive care. This is about working effectivel­y between primary and secondary care. We haven’t got a full sight on the workload of primary care, and that’s why our solution to this is a shared solution.”

“A good example of this has been in renal medicine. Their letters absolutely hit you in the face if something is required by the practice, and that has proven successful. We’re now looking at rolling that out across the trust.”

Dr Matthew Lewis, medical director at UHNM, said he recognised that GPS had an ‘extremely high’ workload, and said it was ‘probably not realistic’ to expect them to read every word of every outpatient letter.

He added: “The specific issue around this prevention of future deaths alert was in relation to changes in medication. GPS have been very clear in directing us towards the practice of the renal team. The renal team have changed their letters so they have bold text for changes in medication, and they also have sections in their letters which are very clearly stating actions for GPS, which makes it easier for our partners in primary care to carry out those actions.” wboard members were told that while there were no plans to write outpatient letters in anything other than English, electronic versions could be sent to an online portal, which would allow patients to translate them into other languages.

 ?? ?? COMMUNICAT­ION: GPS will now receive ‘clearer’ letters sent by the UHNM.
COMMUNICAT­ION: GPS will now receive ‘clearer’ letters sent by the UHNM.

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