OLDER people who need nursing care are being put into cheaper residential homes to save local authorities money, according to William Laing, an economist, in Nursing Standard (March 28). “There is a degree of cheating, with local authorities having financial incentives to place people in cheaper residential care rather than in nursing care,” he says.

He also says that the number of older people receiving formal care services is decreasing and the level of service is being downgraded. “Nursing home care is moving towards residential home care, and residential home care is moving towards domiciliary home care.”

Patients who have been in hospital are also at risk because GPs are not being given information about their stay, reports Health Service Journal (March 29). An NHS Alliance survey of 650 GP practices shows that 70 per cent of them have either very or fairly often received discharge summaries late. As a result, 58 per cent say that clinical care has been compromised over the past year and 39 per cent say patient safety has suffered.

Patients are being put at risk, the survey says. “GPs are plagued by delays in essential information and by inadequate detail even when it is provided.” GPs depend on prompt discharge summaries for prescribing information about medication that has been stopped, diagnostic test results and information on any pending results.

One GP says that when summaries do arrive, often late, some are incorrect, some provide no diagnosis and others do not have the patient’s name. Some never arrive.

Dr Michael Dixon, chair of the NHS Alliance, says that trusts should not be paid until they finish the job, which includes providing “timely, accurate discharge information to a minimum standard”.

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