Guidance for doctors on copying letters to patients

Copying letters to patients is on the whole beneficial. There are instances when it’s advisable for doctors not to copy patients in but these instances should be the exception and not the rule.

While the copying of letters is not a contractual obligation, there is strong support for the practice. Good communication with patients in written form is recognised in the GMC’s Patient-centred care – tomorrow’s doctors. It says: ‘Patients will soon routinely receive copies of letters written about them by one professional to another. Doctors of the future will need to write letters in plain language.’

The Department of Health expressed its support in Copying letters to patients, in 2003. It says: ‘The general principle is that all letters that help to improve a patient’s understanding of their health and the care they are receiving should be copied to them as of right.’

Some trusts have adopted it as trust policy

There are several advantages to both doctors and patients in copying letters, including a reduction in follow up appointments and the ability to clear up any misunderstanding from the consultation.

Consent and confidentiality

DoH guidance suggests that patients should routinely be asked during a consultation whether they want a copy of any letter written as a result of that consultation. There should also be a clear process for recording their views, similar to that for recording their consent to treatment.

To ensure confidentiality, it is advisable for the doctor to establish which address the patient wishes the letter to be sent to.

If the patient is under 18 years of age and Fraser/Gillick-competent, the doctor needs to discuss how they would like the information sent to them to avoid parental intrusion.    

Some patients may wish to receive letters by email.

Writing in plain English

As the purpose of the letter is to inform another health professional, it’s worthwhile giving some consideration to the patient’s understanding of the language. The tone of the letter also needs thought, as it may run the risk of seeming blunt or insensitive about a serious condition or mental illness.

In some instances, if time allows, consultants might tailor letters to the patient.

Pitfalls doctors should avoid when copying letters

It may not be advisable to copy letters to patients who will either struggle to understand them or react adversely. In such cases it may be advisable to write to the legal guardian or executor of a power of attorney.

In paediatrics, it is good practice to provide parents with information about all health consultations, and includes writing to the parents and sending copies of clinic letters and writing directly to the young person.     

The few exceptions to this practice fall under the banner of ‘safeguarding’ where there are concerns or suspicions of fabricated and induced illness or an ongoing police investigation.

Read the BMA’s full guidance for doctors on copying letters to patients.   

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One Response to “Guidance for doctors on copying letters to patients”

  1. Sue Dubois says:

    I requested copy letter after seeing a consultant? or registrar. I was sent on a GPs urgent 2 week cancer appointment. SO worried.
    That was 2 weeks ago. I know that he works between at least 2 hospitals. I seem to spend a lot of time “Chasing” letters that I’ve asked for to ensure I understand what and why I am having scans, procedures etc.
    Is there not an administrative agreement for all the various Med Secs that these Medics/surgeons etc. have cross- hospitals – to send letter off unsigned to hasten and not to have these letter lingering in the “Tray” unsigned for many days.
    Why should ailing patients get caught up sorting out a simple lack of info. between several locations 1) GP,2) Hospital No. 1 to see him first 3) the hospital where the scan is going to be then 4) Another hospital to see him or “someone in team” when results known which in my case is day after the scan.

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