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St James' ED General Management
Discharge Letters & Information to GPs
- Most patients attending A&E can be discharged back to their GPs where possible.
- It is ESSENTIAL that you provide the GP with some information regarding his/her patient. Therefore wherever possible you should use the duplicating letters available. Sometimes this may be inadequate and an accompanying photocopy of the Accident & Emergency card will give the GP all the information. This can either be given to the patient to take it with him to his GP or sent via post.
- In a more complicated case you may wish to write a hand written letter for the GP.
Information to the Patients and use of Instruction Cards
- The commonest reason for re-attendance is a returned patient troubled due to poor advice resulting in inappropriate expectations. Try and provide complete care on the first visit so that further visits become unnecessary.
- Instructions in the form of cards exist for a number of conditions and are available in all clinical areas, if these are given and explained to the patients difficulties may be avoided later. Make sure that patients who are to be discharged with no further follow-up, either in the Returns Clinic or by their GP is given appropriate advice regarding rehabilitation, analgesia, and return to work (see below).
Sick Notes/Certificates –
- If patients need to stay off work they may need a certificate. There are two main types, self-certifying notes (SC2) and medical certificates (Med3). Self-certifying notes are available from the Accident & Emergency Reception. A self-certifying note will cover an absence of up to 7 days. If the patient takes a self-certifying note, but later finds that their absence is longer, their GP will be able to provide a medical certificate (med3). Medical certificates are only available from medical staff.
- If you advise a patient that he/she will definitely need more than 7 days off work you should offer a medical certificate during their consultation. In general terms you should avoid giving a med3 for more than 2 weeks.