| Key information missing from discharge summaries received by primary care from discharging teams |
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| Poor quality of written handover content in discharge summary sent by discharging teams to primary care |
Discharge letters too long and detailed, with key information not easily standing out Conflicting or incorrect information within discharge paperwork Evidence of ‘copy and pasting’ of same information into different boxes on discharge summary Lack of clarity on next steps in patient’s management and what actions GP is expected to take Handwritten letters frequently illegible Poor coding Discharge summaries sent that are still in draft format
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| Lack of clear explanation and instructions for primary care regarding patients’ medications at discharge |
Changes made to patients’ regular medications not clear from discharge summary GPs asked to prescribe medications but lack of clear instructions on dose titration, frequency, or whether training has been provided for patients Prescriptions of some medications, including benzodiazepines and opioids, with no discussion with patients regarding side effects, plan for reducing regimen, or management of withdrawal
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| Lack of clarity regarding patient requirements and instructions for therapeutic adjuncts and care equipment |
Lack of detail provided when GPs asked to prescribe care equipment; for example, size, type, product code No instruction handed over to community teams regarding management of therapeutic adjuncts; for example, clamping of catheters
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| Poor communication between primary and secondary care teams regarding follow-up arrangements and referrals |
Lack of communication from secondary care teams on which referrals have already been made by them to community services and what GP is expected to do Poor description of clinical context in which referral is warranted Lack of indication of timeframe and urgency in which referrals are expected to take place
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