02 January 2017

Developing a clinical standard for outpatient letters


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Dr Phil Kozcan


New standard for outpatient letters

Outpatient letters are a mainstay for communicating between GPs and hospital colleagues following a consultation in clinic. As outpatient services grow and evolve to care for patients who are living longer with multiple and complex needs and who are treated in a range of settings, communicating clearly and concisely is essential to good care.

Outpatient referrals are growing by tens of thousands. GP referrals to outpatient clinics grew 4.4% to 3.6 million in the year to last April. First outpatient appointments grew 3% and attendances grew nearly 2%.

With the heavy volume of outpatient letters and work it is vital that communications provides the right information for seamless care. But at present there are no standards for writing outpatient letters and the quality of the information they contain varies widely, putting safe, high quality care at risk.

The PRSB is leading work, supported by the Royal College of Physicians Health Informatics Unit, to develop a standard for the content of outpatient letters. This will ensure no matter where a patient attends a clinic, their doctor or healthcare professional will have all the necessary information to provide the best care possible.

Developing standards for outpatient letters involves extensive consultation through workshops, discussion and surveys involving everyone with an interest in improving health and care information sharing. That includes clinicians, patients, health and care professionals, and IT system suppliers. A workshop is being held on 19 January to kick off this project and an online survey will follow in February. To find out how to get involved contact info@theprsb.org or informatics@rcplondon.ac.uk.

The new standard is due to be ready in the early summer of 2017. Following that the NHS will issue guidelines to healthcare organisations requiring them to send outpatient letters electronically using computer-coded messages and PRSB standards for structuring the clinical content of the letter. That way letters will be consistent and shared in a timely way with GPs and patients to aid good care.

The outpatient letter standard is part of a larger piece of work to standardise flows of patient information between health and care settings. This and the other transfer of care standards the PRSB is leading on will help us move closer to the vision for truly integrated care and will ensure that patient records are accessible and understood by everyone who needs to see them.

There are additional benefits for clinicians. The evolving technology that supports sharing patient information digitally means clinicians only need to record data once in their own system; this and other transfer of care documentation will be largely automated and the receiving clinician's clinical systems will be able to integrate the information into the patient's record.

What we are describing is a whole "end to end" process that will support integrated care. It will also require all parties involved to collaborate and evolve the system over time so that it meets the needs and expectations of both clinicians and patients. The PRSB's role - to create consensus-based clinical standards – is critical to the success to this work.

You can find out more information about the PRSB, standards and how they are being implemented in health and social care at www.theprsb.org.


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