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Medical records: Doctors’ and patients’ experiences of copying letters to patients

Specialist Registrar, Psychiatry, John Hampden Unit, Stoke Mandeville Hospital, Aylesbury, Bucks HP218AL

Graham K. Murray

Research Associate, Department of Psychiatry, University of Cambridge, Box 189, Addenbrooke’s Hospital, Cambridge CB2 2QQ

Nigel Hymas

Consultant Psychiatrist, Box 179 Addenbrooke’s Hospital, Cambridge,

Neil Hunt

Consultant Psychiatrist, Fulbourn Hospital, Cambridge CB15EF

Declaration of interest

None.

AIMS AND METHOD

We conducted a pilot study to determine patients’ views on receiving a copy of the assessment letter sent to their general practitioner and to determine how psychiatrists’ letter writing practice would be altered in the knowledge that patients would receive copies of such letters. Seventy-six consecutive new out-patients received copies of the initial assessment letter sent to general practitioners. Patients were asked to complete a short questionnaire on how the practice affected them. For each letter, psychiatrists were asked to provide details of anything of importance that had been omitted from the letter that in their normal practice they would have included.

RESULTS

There was a broad range of responses on how patients felt about the letters. Only two patients found the letters unhelpful, and 83% expressed a positive desire to continue receiving letters, even though initially 18% found the letter distressing. For 56 out of 76 patients, psychiatrists stated that they composed and sent out the letter to the GP in accordance with their usual practice and copied the letter to the patient in an unaltered form. For 17 patients, the psychiatrist stated that some information he/she would usually have included in the GP letter was omitted in the copy the patient received. In a further 3 cases, the psychiatrist sent no letter to the patient.

CLINICAL IMPLICATIONS

Patients found it helpful to receive copies of their assessment letters. Psychiatrists might require training and reassurance about this policy before implementation.

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