GPs are complaining this week that they are 'plagued by delays' and errors in the quality of discharge summaries many of them are sent by hospitals (see news story). According to an NHS Alliance survey, almost 60 per cent say clinical care has been compromised as a result and almost 40 per cent say patient safety has been affected.

GPs are complaining this week that they are 'plagued by delays' and errors in the quality of discharge summaries many of them are sent by hospitals (see news story). According to an NHS Alliance survey, almost 60 per cent say clinical care has been compromised as a result and almost 40 per cent say patient safety has been affected.

The large-scale survey reveals not just poor performance but huge variation in quality of information even in the same hospital.

The alliance has condemned 'institutional contempt' and called for the rules to be changed to allow commissioners to withhold payment when information from providers is not good enough. It also wants the model contract to introduce minimum standards on discharge information.

Will this work? Some argue that using financial penalties does not encourage collegiate thinking but it is true that fines for so-called bed blocking did galvanise action, turning paper policies into real outcomes. It is what commercial organisations would do.

At the same time many hospital consultants and managers despair at referral letters from GPs which can be no more detailed than 'see this patient'. But it would wrong to use that frustration as a way of minimising what is clearly a serious and long-standing problem. What the combination of a more flexible finance system, joined-up technology and GP commissioning provides is a very good chance to resolve it.

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