Dear Doctor – the importance of improving outpatient letters

The RCP Health Informatics Unit is co-delivering a Professional Record Standards Body (PRSB)-led project, commissioned by NHS Digital, to develop new standards for outpatient letters. Here, the team discusses the importance of outpatients letters, and why it is important that it is brought together with the convenience of technology, to create new standards for communication.

In an age where digital rules, a written letter is still integral to communication in the healthcare profession. Outpatient services are diverse and evolving rapidly, involving a multitude of medical specialties, nurses and allied health professionals, and serving a huge population with varying conditions and clinical needs; an ageing population, more people living with multiple health conditions and a shift from inpatient to outpatient care, has resulted in an increase in referrals and attendances at outpatient clinics.

As a result, the important role that outpatient services play within the NHS has grown significantly.

From April 2015 to April 2016 the number of referrals made by GPs increased by 4.4% to 3.6 million. Over the same period, first attendances at consultant outpatient clinics also increased by 3.0% to 4.9 million and total attendances saw an uplift of 1.9% to 15.2 million.

This highlights the need for outpatient letters to be clear, concise and provide sufficient information to ensure uninterrupted patient care and management. However, the quality of such letters is still variable, potentially impacting patient safety and care.

Standardising outpatient letters will support improvements in patient safety and patient care by ensuring that the right information is shared with the right people at the right time.

RCP Health Informatics Unit

With more patients receiving outpatient care than ever, it is important that the right information is shared quickly and consistently between hospitals, GPs and patients. Standardising outpatient letters will support improvements in patient safety and patient care by ensuring that the right information is shared with the right people at the right time.

This project will build upon existing evidence and will involve widespread consultation with patients, clinicians, healthcare professionals and IT system suppliers to ensure that the standard meets the needs of both the senders and recipients of outpatient letters. As part of the consultation process the HIU will be hosting an interactive workshop on 19 January 2017 and an online survey (due to launch February 2017).

New guidelines from NHS England, due to take effect in October 2018, require electronic transmission of outpatient letters as structured messages using standardised clinical headings. This will support and facilitate consistency and timely sharing and access of information, to help ensure that patients are able to receive high-quality care, when and where they need it.

Final versions of the standards will be ready by May 2017. The PRSB will be seeking endorsement and support for the standards from key patient and professional bodies and specialist societies at that time.

Follow @RCPLondon to hear about the work of the HIU. To find out more or to get involved  please contact informatics@rcplondon.ac.uk.