Patient Letters: Do We Really Need More Research?

Two leading doctors have challenged the need for further research and pilots on the NHS Plan’s pledge to give patients copies of letters about and summaries of their treatment and care.

Professor Sir Cyril Chantler, senior associate at the King’s Fund and Mr James Johnson, chairman of the British Medical Association’s joint consultants’ committee, point to the implications for the development of electronic health and medical records if the practice of sharing information with patients is delayed until the pilots are completed.

In a letter to the BMJ, they say that patients have a right to know what is being written about them and, if this material is to be electronically stored, then they must be informed under the rules of the Data Protection Act and in accordance with the common law of confidentiality.

”An electronic health and medical record is vital if we are to develop an integrated NHS,” they write.

Further, Sir Cyril and Mr Johnson argue that refusal to provide the information if the patients wish is a denial of their autonomy.

”The idea that patients should receive copies of letters and summaries is not new, and research has shown that it meets with high satisfaction from the patients,” they say.

”Given the urgency of developing electronic health and medical records, we wonder why any particular difficulties in recommending the practice nationally could not be sorted out through ‘action research’ after introducing the policy rather than waiting until 2004.”

Documents on the DH website confirm that there is a “Copying Letters to Patients Initiative which is working towards a full implementation of the policy by April 2004.

A programme of pilots is planned to look at issues including: the style and content of the letters; the effectiveness of software systems; access by people with language, sight or learning difficulties; guidelines and model letters; staffing arrangements and particular issues around mental health, children and carers.

Barbara Meredith, who chaired the DH working group whose report led to the pilots, told E-Health Insider that the work due to be done would take the form of action research intended to help roll out the policy. She maintained they were necessary.

“There are some very important issues behind the policy which are teased out in the working group’s report,” she said.

“Basically I’m totally committed to the policy because it’s one strand in improving communication with patients,” said Ms Meredith who is also policy and communications manager for Age Concern London.