Table 3 Themes identified during analysis

Structure and content of discharge letters

“I did use the format that [CLINICIAN] suggested, which was basically diagnosis, problems like the issues, what do you want [GP] to do about it… literally diagnosis, what the issues were, what the actions were, and if I wanted to chat about all the other stuff, just to put that underneath, and if we ever need it, it’s good to have it there.” [PCS9]

Communicating patient (complex) palliative needs

“the GP Uh, needs to know that this pain was complex and challenging, and [if] it’s not written down. Then there is a fail.” [PCS18]

Responsibility of care

“I think in our heads we’re quite clear about responsibility, but maybe we’re not. But I always think, you know, when someone is in the building they’re our responsibility, when they leave the building, we have responsibilities to them to provide specialist palliative care, but the ultimate responsibility is with the primary care.” [PCS11]

Patients receiving letters

“I was actually surprised that we don’t, there was one letter that was copied to a patient, but other than that we don’t routinely copy letters and it did make me think actually, should we be copying, you know, giving copies of letters to patients.” [PCS23]

Variability in mode and transmission of discharge communication

“I think members of the team maybe do things slightly differently as well. Sometimes it might be an email to the GP. Sometimes it might be the more formal letter, the GP letter from the nursing team, or sometimes it is, it’s just telephone call correspondence...” [PCS13]

Computer systems, shared and cross-service integrated records, and technology issues

“I would say the challenge is that everybody you know GPs are on a different computer system to us who are separate from the hospital so that you know the hospital can’t see our discharge letters...” [PCS12]