E-discharge: standard clinical headings required by Dec

All NHS providers must send digital discharge summaries to GPs using standard clinical headings by December this year, the new draft NHS standard contract says.

The contract, which is out for consultation, also encourages providers to adopt structured messaging for discharge summaries, but this will not become a formal requirement until next year’s contract, NHS England head of enterprise architecture Inderjit Singh told Digital Health News.

The new General Medical Services contract will also make it a requirement for GPs to be able to receive discharges electronically from next month.

All four principal GP system suppliers now have the functionality to be able to receive structured documents directly, as specified under the latest GP Systems of Choice contract.

“The key message to the service is we are asking to move to clinically consistent headings, but also structured documents and that functionality is in place with all GP system providers,” said Singh.

The requirement to send electronic discharge summaries was included in last year’s NHS standard contract and was mandatory from last October.

According to the first round of results from NHS England’s new Digital Maturity Index, around two thirds of trusts are now sending the majority of their discharge letters to GPs electronically.

Singh said NHS England’s strategy has been to align contractual levers with professional buy-in and supplier readiness to ensure uptake is high.

The new draft NHS standard contract includes the requirement for provider organisations to use the Academy of Medical Royal Colleges clinical headings, published in 2013, for discharge summaries.

The contract says they must do this by December this year, by which time all GPs should be getting a standard set of information about their patients on discharge.

This year’s contract will also “strongly encourage” providers to start using structured messaging, although this will not become a formal requirement until 2017, Singh added.

Singh explained that while moving straight to structured messaging is not yet mandatory, by signalling it early trusts have a chance to “get ahead of the game”.

Structured documents will make it much easier for receiving organisations to send information, such as referrals, back into acute trusts and will also make it easier to share information with other care sectors such as social and urgent care, he said.

NHS England is looking for acute trusts and other providers that want support for local pilot projects to start using structured messaging.

Singh said some organisations have already expressed an interest and the national commissioning board is “keen to encourage other provider trusts to come forward and work with us on using the functionality that GP providers have now made available”.

The Health and Social Care Information Centre ‘transfer of care’ team have produced a toolkit to help local organisations adopt the Academy of Medical Royal Colleges headings and provide technical specifications for implementing the transfer of care domain messages.