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Discharge letters must be coded and timely, says Alliance

21 October 2008

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GP practices should be sent discharge letters within 72 hours every time a patient leaves hospital, says the NHS Alliance, which claims this would facilitate practice-based commissioning (PBC) and improve patient care.

The primary care representative organisation says the discharge information should include the correct healthcare resource group (HRG) coding, to enable practices to ensure accuracy, correct any errors or to establish missing information.

The recommendation follows the recent Health Select Committee report that said NHS foundation trusts are not doing enough to shift care out of hospitals into the community. In response, trusts said this was due to poor commissioning.

“Shifting the blame is neither productive nor accurate,” the NHS Alliance says. “Effective commissioning depends on good quality, timely and accurate data on hospital activity. That applies to PCTs and practice-based commissioners alike. Yet too often, data is late, inaccurate and fails to include crucial information.”

According to the Audit Commission, around one in 10 patient episodes were incorrectly coded last year – around one million hospital admissions. That results in a “gross financial error” of around 5%, the Commission said.

The NHS Alliance’s solution is designed to remedy the problem of PCTs and practice-based commissioners having to wait “weeks or months” for information from hospitals.

“When this arrives, it may contain errors such as identifying the wrong GP – disastrous for those involved in PBC,” the Alliance said.

Under its proposal, once the practice has received the hospital’s discharge letter, containing the HRG code, the GP would confirm with the PCT that the records are accurate and the hospital should be paid.

“If any trust does not deliver the full contract, then there should be no argument that payment should be withheld,” said NHS Alliance chief executive Michael Sobanja.

He added: “The Health Select Committee is absolutely right to point to the imbalance of power between Foundation Trusts and PCTs. This proposal would go a long way towards redressing that.”

NHS Alliance

Health Select Committee Report

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