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Simon, >This (GP communication) is where the stick has to accompany the carrot. I >intend to introduce a somewhat punitive system. No letters to GPs = bad >term report and shitty reference. Shutting the gate after the horse has bolted, methinks ...that won't actually alter the fact that they didn't write any GP letters. But adding "GP letters sent %" to the monthly "number patients seen by Doc" figures that used to adorn the wall of the Docs Office in Hobart might generate some healthy competition ;-) I hope one day technology should obviate the NEED for doctors to write GP letters. In my Utopian A&E, any piece of clinical information is recorded ONCE only (and let's not forget that voice- and handwriting systems exist). Decent relational database software then sorts out what info is required for what processes (clinical info for lab & X-Ray staff, GP letters, etc, demographics for billing / planning etc), and makes sure it gets there. The failure of the system to do something useful like automatically relay information to GPs should result in a bad reference for the programmer (and system designer), not the user :-) Jon Bury (spent hours on the phone last to various distant hospitals night trying to establish details of a patient's previous admissions with them. Roll on electronic patient records and the NHS intranet, I say) ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%