The progressive change to structured correspondence and its delivery to improve handover of care has been shaped by successive ratcheting up of the requirements in the NHS Standard Contract.
Notable changes in date order
From 1 October 2015, the Technical Guidance (section 34.27) in the 2015/16 Standard Contract required secondary care to use secure email or direct electronic transmission to replace secure fax as the transport route for discharge summaries to any GP or NHS Trust/NHS Foundation Trust.
By no later than 1 December 2016, for Inpatient and Daycase Discharge (only), the Technical Guidance (section 39.22) in the 2016/17 Standard Contract required providers to implement the Academy of Medical Royal Colleges (AoMRC) clinical headings.
By 1 October 2018, in addition to Inpatient Discharge, the 2017/19 contract required that Emergency Care Discharge and Clinic Letters used the AoMRC clinical headings.
In addition, from 1 October 2018, the above 2017/19 guidance document required direct electronic transmission only with the elimination of secure email and paper from 1 October 2018 onwards.
By no later than 30 September 2021, and annually after, the secondary care provider and co-ordinating commissioner need to assess interface working (including discharge and clinic letter communication) and implement an action plan to address any deficiencies, and report this to their respective boards. Relevant areas of the 2021/22 Standard Contract for Transfer of Care include sections 2.6, 39.15, 39.16, 39.21, 39.22 and 39.23.
FHIR structured messaging
Transfer of Care FHIR structured messaging is an England wide requirement, and each secondary care provider’s correspondence solution must cover residents either inside or outside of its normal catchment area. During the financial year 2021-22, if secondary care providers have not yet gone live with Transfer of Care FHIR structured messaging then they should have well developed plans that would allow this to happen imminently.