Failures of communication
Good management requires all members of the communication net to be conscious of who is doing what
Underpinning good patient care is good communication, and this goes beyond establishing good relations with patients. In today’s team approach to delivering healthcare, communication has to extend to more people and there are therefore more opportunities for it to fail.
Communication between primary care, secondary care and social and voluntary services should be seen not as a chain, but as a communication net, within which any one member may need to communicate with any other. Good management requires all members of the communication net to be conscious of who is doing what – an adequate standard of continuing medical care can be achieved only if all participants – both medical and nonmedical – understand their roles.
Keeping people informed in the interests of continuity of care must be balanced against the need to maintain confidentiality, and both these issues should be borne in mind when sharing relevant information about patients.
Unless the patient asks you not to, it is entirely appropriate to share information about patients with people involved in their care.
Box 16: Communicating with colleagues
“Doctors working in multidisciplinary teams should ensure that there are clear lines of communication and systems of accountability in place among team members to protect patients.”
Medical Council, Guide to Professional Conduct and Ethics for Registered Medical Practitioners (2009), para 46.1
Recording essential information
What you include or leave out of the record is a matter of professional judgment
Inadequate medical records are the underlying cause of many failures of communication – the records are the essential tool of communication between members of the multidisciplinary team. Subtle but significant changes may be missed when several different doctors see a patient over many days, unless adequate information is available from previous examinations.
What you include or leave out of the record is a matter of professional judgment, but you should take care to include all information that other members of the team will need to continue care of the patient safely. As months or years may elapse between treatments or illnesses and staff may have changed in the meantime, the records should also serve to reconstruct events at a later date without recourse to memory.
Box 17: Sharing care with colleagues
Ensure that colleagues who deputise for you, whether formally or informally, are fully aware of all relevant details of the patients for whom they are responsible.
Practices should establish protocols for the transfer of relevant information between doctors who cover for each other, particularly in co-operatives and when deputising services are used.
If it is in the patient’s best interests and you have their implied or express consent, welfare and voluntary agencies and family carers should be given any relevant information.
For hints on keeping good records, and advice on access to and disclosure of medical records, phone MPS’s Communications Department and ask them to send you a copy of the MPS booklet, Medical Records.