Will the lead clinician please stand up?

Editor—In his personal view Gannon shows that a lead clinician with clear ownership of patients' cases is crucial in ensuring continuity of care.¹ I know who the lead clinician is—the general practitioner. Secondary care now seems so refined and pigeonholed that there are no remaining generalists, excepting accident and emergency and geriatricians, left in hospitals. I have been asked by a cardiologist in the left ventricular function clinic to refer a patient to the general cardiology clinic because the echocardiogram is fine but the patient might have angina.

I recognise Gannon's scenario and could describe several similar instances every year, thankfully not all with such sad ends.

The general practitioner is well placed to provide the overview, but the key problem hampering this role is the quality of communication he or she receives from secondary care. This falls into two main categories: prompt, but illegible and incomplete; and late, but typed and comprehensive.

If general practitioners are to be the lead clinicians, then give them prompt, legible, succinct information. That would be a start.