The discharge letter plays a crucial role in continuity of care from secondary to primary care. We found no existing study of outpatient discharge letters, including Mental Retardation services. New Ways of Working for psychiatrists has encouraged the discharge of stable outpatients to primary care in order to provide a responsive, flexible service. This study set standards for discharge communication and identified areas for improvement.

This was a retrospective random audit of 30 service users discharged from a psychiatric outpatient clinic. Standards were set with consultant psychiatrists and general practioners. Data was collected from the service users’ last two clinic letters using a pre-developed audit tool and compared the current practice with the standards identified.

Standards for status and future planning were largely achieved with reference to current mental state (97%), current medication (90%), other LD professionals involved (95%), advice and how to re-refer (90%).Standards for historical factors were partially achieved; including summary of contact with services (70%), summary (57%) and evaluation (67%) of treatments received. Some standards were not achieved; including requesting view of primary care prior to discharge (27%), statement of capacity (23%), risk factors (23%) and relapse indicators (27%).

The audit showed areas of good practice and areas for improvement. Results were disseminated to MDT's and a template developed for outpatient discharge letters. A re-audit has commenced to ensure progress in this important information-sharing process and to enhance the delivery of safe and effective health care.