Emergency care discharge standard

Nearly two million people attend emergency care services each month. Sharing discharge information between emergency care and GP practices is essential for ensuring patient safety and good ongoing treatment. Relevant and useful information must be transferred quickly to GPs and their clinical teams, reducing the risk of transcription errors and improving the patient experience.

The NHS Long Term Plan sets out the digital plan for the NHS which includes greater use of electronic systems and shared care records to support person-centred care, ensuring clinicians have access to the information they need to provide high quality care in health services.

The standard defines the information content and structure that should be used to create an emergency care discharge. It is designed for sending coded and structured electronic discharges which can be transferred to primary care and other systems and used to populate their record systems. Full electronic transfer will improve safety through reducing the risk from re-typing information and make that information fully available in the receiving electronic record systems more quickly. It can also be used for paper or electronic documents, although some of the benefits will not be realised in doing this.

• Improved patient safety by:
• having information which is needed for safe continuity of care available on a timely basis
• avoiding transcription errors when medication information is electronically transferred to the GP record (following clinician review), without the need for re-entry
• Improvements to patient care and patient satisfaction by:
• having consistent and timely information (including medications, diagnoses, procedures and allergies) transferred to all relevant care professionals and their GP practice
• providing patients with legible up to date information about their stay in hospital.
• Support for new more integrated and person-centred ways of working, including:
• increased efficiency for multidisciplinary teams by providing structured and coded information on diagnoses, procedures and medications which can be reused for new ways of integrated working across health and care.
• Time savings for NHS organisations by:
• Avoiding the need to re-type information into the GP record
• Increased opportunity for future development of patient led care by ensuring interoperability between multiple systems, including personal health records.

The standard is evidence based and developed through extensive consultation with clinicians, professionals and people across health and care involved with hospital discharge. Full details of how it was developed are available in the final report in the supporting documentation.

Discharge after any admission to a type 1, 2 or 3 emergency care unit.

• Discharge from hospital after any inpatient stay, including day cases – refer to the eDischarge Summary Standard
• Discharge after mental health inpatient stay – refer to the Mental Health Inpatient Discharge Standard
• Transfer between hospitals – although much of the content may be appropriate
• Discharge from outpatient treatment or other community based period of treatment – refer to Outpatient Letter Standard

The hospital electronic patient record (EPR) is expected to be able to generate much of the discharge summary from information recorded in the record such as attendance details, diagnoses, procedures, medications, patient demographics and other administrative information, with the person completing the record adding other information such as the clinical summary, plan and requested actions.

The standard comprises 18 sections, 10 mandatory (must be included), 8 required (should be included where the information is available), 0 optional (local choice whether to include the information).