Improving Communication to General Practitioners (GPs) Following Day Attendance on an Oncology Admissions Unit

Abstract

Background: Weston Park Hospital (WPH) is a specialist cancer hospital, within the Sheffield Teaching Hospitals (STH) NHS Trust. It houses its own admissions unit (WAU) where cancer patients are seen by the on-call medical team for assessment. Patients who are receiving treatment for cancer can self refer via the on-call nurse practitioner, be referred by the GP or be referred by the other hospitals for further management. Patients are either discharged from WAU or are admitted to the in-patient wards for further care. Traditionally, no formal discharge letter is required for patients who are discharged directly from WAU but if necessary a hand-written outpatient prescription is given to them with instructions to take a copy to their GP. An electronic discharge letter may be produced but this is at the assessing doctor’s discretion. A datix was recently generated when a patient was prescribed medication on discharge from WAU but this was not subsequently added to their regular repeat prescription. Additionally we found that the nurse practitioner takes a number of calls from patients regarding prescriptions and difficulty obtaining these from their GP. This highlights a clear failure in communication between WAU and the GPs in the community, thus risking patient safety. We found that of 66 WAU reviews in one week, 22 patients were discharged on the same day and only two discharge letters were produced. The aim of this quality improvement project (QIP) is to improve communication to the GP through implementation of a standard operating procedure where all patients discharged on the same day from WAU are given an electronic discharge letter which is also sent to the GP.