Up to this point their experience has usually been reasonable – the referral has been done promptly, and the hospital has seen and dealt with their problem. They have been told: "We'll let your GP know what is happening…what tablets you need…the test results."

So, sometime later (usually after two to four weeks), they come to see me for the results and to discuss what they mean.

And sadly all too often I do not have the results. I am operating in an information void. I just do not have the information I need to help my specific patient, with their specific problem. I'm sure the consultant will have given sensible advice, and written me a sensible letter. I'm sure the radiologist will have reported the x-ray films accurately.

But right here, right now, when doctor and patient are meeting, the information has not got to where it is needed. I feel frustration.

And the patient is frustrated. They have been and had tests done. They have lost time at work. They have their worries about what the results might be. They have family and friends, and employers and insurance companies who need to know what is going on with their health. They want to make realistic plans so they can deal with whatever illness they have. Neither patients nor doctors have time to waste.

And yet this scenario of the GP and patient meeting in an information void and each wasting time is happening frequently in the NHS. As a GP, I encounter such scenarios up to six times a week.

I deal with about 140 direct patient contacts each week (face-to-face appointments, phone appointments, visits). You can work out the system-wide implications of this problem from those figures.

What I am describing as the information void is something that many patients, and all GPs will recognise easily. Indeed many NHS staff shrug and say: "That's just how it is round here."

The recent story of 120 lost mailbags discovered in the Leeds General Infirmary mailroom is remarkable, particularly for the fact that it was only after about two months that people started to wonder where the letters might have gone!

The problem has been present in the NHS since its inception, and is recognised by GPs of any age, and everywhere in the country. Basically the flow of information from hospitals to GPs is haphazard, slow and sometimes non-existent.

The information void is bad for patients, GPs, and the NHS as a whole. Firstly it wastes the time of all concerned. Then it generates extra work chasing up letters and results, and getting them faxed through. This generates the need for extra appointments so thattwo are used, when only one need have been. And this of course increases the pressure on GP appointment systems for other patients.

Then we get into the unkindness of it all. Making a patient wait for results is unavoidable (tests take time to perform). But it is cruel of the NHS as a system to not get results ready and available within an agreed timescale. It adds to the patient's suffering, and also creates an impression of a disorganised and uncoordinated service.

For the hospital staff to say, "the results will be with your GP in two weeks" and the patient to then hear the GP say, "they may have said that, but it's rare for them to achieve that" is a poor service.

It shows expectations being raised, and not met. It is a recipe for disappointment and frustration. In a commercial organisation it would lead to customers walking away.

There is a risk of patients coming to harm as a result of poor information transfer between secondary and primary care. The medical defence organisations can describe many examples of such scenarios being the basis of negligence claims.

There is no need for this information void to exist. It is bad for all of us – patients, doctors, hospital staff. It helps no one. In fact, it generates much extra work, and squanders resources in inefficiency.

As a practising doctor, I see no sign that the NHS as a system is aware of the problem or is doing anything to correct it. Billions are being spent on a new NHS computer system, yet I have seen no evidence so far that it will correct the information void.

For all the great initiatives and reconfigurations that have been inflicted on the NHS in the last 20 years, this basic problem of getting information around the system has not been tackled. For the sake of patients and doctors, and also NHS efficiency, it should be.


Peter Davies is a GP at Keighley Road Surgery, Illingworth, Halifax. He is also chair of the Yorkshire Faculty of Royal College of General Practitioners – an organisation committed to raising the quality of care patients receive by helping GPs to help their patients more effectively.