Newcastle Musculoskeletal Research Group, University of Newcastle-upon-Tyne, Newcastle-upon-Tyne and 1 Queen Elizabeth Hospital, Sheriff Hill, Gateshead, UK
Correspondence to: S. Young Min, Newcastle Musculoskeletal Research Group, Level 4, Cookson Building, University of Newcastle-upon-Tyne, Framlington Place, Newcastle-upon-Tyne NE2 4HH, UK. E-mail: Steven.YoungMin{at}ncl.ac.uk
SIR, The NHS plan (2000) [1] states that letters between clinicians about an individual patient's care will be copied to the patient as of right and it was proposed that this policy should be fully implemented by April 2004. This policy will have an impact on the nature and content of correspondence between health professionals and will require systems for recording the patient's informed consent and their choice of how letters are to be provided [2]. We used a questionnaire in a hospital out-patient clinic to explore whether our patients felt that they had been well informed, what the demand for copied clinic letters would be, and what additional demands such activity would place on our service. A voluntary, anonymous questionnaire was handed to consecutive patients attending new and review out-patient rheumatology/general internal medicine clinics at the Queen Elizabeth Hospital, Gateshead. Questionnaires were completed after patients had seen their doctor (the questionnaire can be seen at Rheumatology Online).
Two hundred questionnaires were issued, of which 122 (61%) were returned. The questionnaires were 94% complete with only 103 blank answers to 1708 possible responses. Seventy-six per cent of respondents found that the amount of information they were given was just right, though 76% still wished to receive a copy of the clinic letter. Fifty-three per cent of respondents were willing to contribute to the cost of sending these letters. Sixty-four per cent would address concerns raised by the letter to their general practitioner (GP), whilst only 27% would contact their hospital doctor. Nineteen per cent of respondents preferred to receive a separate patient letter, devoid of medical jargon, though 67% still wanted to see the letter sent to their GP. A majority (71%) wished to receive a letter even if it might lead to undue anxiety. Eleven per cent required letters in large print and there were individuals who required an audio tape of the letter or the ability to collect the correspondence directly rather than to receive it by post. Sixty-four per cent felt that copying correspondence was an appropriate use of NHS funds. A crude estimate of additional hospital costs per consultant per year was calculated at £5500 (the working out of the basic cost analysis can be seen at Rheumatology Online). We estimate that approximately three-quarters of our hospital clinic patients will require copies of correspondence. There was no relationship between the amount of information that patients felt they had been given and the desire to have a copied letter.
It would appear that most enquiries stimulated by such correspondence are likely to fall to primary care. We can confirm that large-print letters, audio tapes and allowing patients to collect letters will be required. The copying of correspondence to patients involves additional costs and these need to be met if the goals identified in the NHS plan are to be delivered.
Ethical approval was not required for this work and none was sought.
Supplementary data are available
at Rheumatology Online.
The authors have declared no conflicts of interest.
References