Authors: Tom Bannister / Codes: SLO7 / Published: 01/05/2024

Scope / Reason for development

Adult and paediatric patients are directly discharged from the emergency department.

To provide guidance on effective communication with patients and General Practitioners for emergency department staff discharging patients back to primary care. This should be read in conjunction with other associated guidance Emergency Department Out of Hours Discharge Medications, Giving Information to Patients in the Emergency Department, Management of Investigation Results in the Emergency Department

Summary of Recommendations

  1. Prior to discharge ensure the patient understands their diagnosis and treatment plan. The use of patient advice leaflets for common conditions is strongly recommended.
  2. Do not tell patients to routinely see their GP after discharge. 
  3. If it is necessary for a patient to see their GP after discharge, ensure that the reason for this is documented in the ED discharge letter and that there is a reasonable expectation the GP surgery will be able to address their patient’s clinical problem. 
  4. In general, GPs should not be asked to chase up the results of investigations requested by the emergency department. 
  5. Direct referrals (after discharge from the ED) to specialists should be used for patients with a firm diagnosis that will clearly require urgent assessment or where there is significant concern of an urgent nature e.g., suspicion of cancer (2 week wait). 
  6. The ED discharge letter is a key element in ensuring safe continuity of patient care, it is essential to ensure that it is accurate and has all the appropriate information for GPs to continue to provide care for their patients. It should be sent in a timely manner, preferably electronically. 
  7. Provision of a Statement of Fitness for Work should be issued by the ED to those patients who are clearly not going to be fit for work after the 7 day ‘self-certification’ period. 
  8. Information regarding registering with a GP should be readily and easily available to all patients attending the ED. 
  9. IT Systems should be in place to allow EDs to easily view the patient’s General Practice electronic health record.

Ensure that you read the full Discharge to General Practice Guideline

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