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Most hospital medicine discharge summaries do not fulfil the requirements laid out in 2008 by the National Prescribing Centre (NPC).

In 2011, researchers from Norfolk audited 3,444 discharge summaries received by a PCT from five hospitals. Each summary was scored against the NPC criteria. Sixty-three per cent of admissions were unplanned and 74.6 per cent of summaries were electronic.

Adherence to patient, admission and discharge information was 77.3 per cent. Adherence to information about medicines and changes to therapy were 67.2 and 48.9 per cent respectively. The most frequent omitted information concerned allergies, co-morbidities, medication history and rationale for changes to therapy.

Although it did not affect the clinical message, some 42.8 per cent of handwritten discharge summaries were only “partially illegible”. However 8.8 per cent were “mostly illegible with the meaning of the clinical message unclear” and 1.5 per cent “completely illegible”.

Discharge summaries written by pharmacists and nurses are more likely to follow NPC guidance than those written by doctors. In particular, doctors reported full details of co-morbidities and medication histories in 50.6 and 41.7 per cent of summaries respectively, while nurses did the same in 61.6 and 43.8 per cent and pharmacists in 58.3 and 50.0 per cent respectively.

The authors suggest that “comprehensive electronic discharge templates” and “effective medicines reconciliation at both sides of the health interface” might help hospitals follow the NPC recommendations.