Copying letters to patients

I read with great interest the recent publications on copying letters to patients (Marzanski et al, Psychiatric Bulletin, February 2005, 29, 51-58; Subotsky, Psychiatric Bulletin, June 2005, 29, 201-203). In a recent research project with 165 patients we found that 84% showed an interest in receiving copies of their consultants’ letters to their general practitioners (GPs). In accordance with the current literature, the interest was somewhat lower in the older age-groups. However, one important aspect has not been investigated, but poses a potential barrier to people consenting to receiving such letters: the way in which consent is obtained. The personal experience of my colleagues and myself is that only about 20-25% of patients consent in writing to receive such letters, although this increases to around 80% when the consultant asks for verbal rather than written consent. Asking for formal written consent appears to be a major barrier to patients gaining access to information, but accepting verbal consent may get around this significant problem. This observation serves as a timely reminder that although we may have the best intentions regarding better communication with the patient, the form in which we do it is possibly more important for the result than the service itself. My suggestion is therefore to accept verbal consent, which could be clearly documented in the patient’s case notes. To aid our administrative staff we also put sticky labels saying ‘copy GP letters’ on top of case notes of those patients who have given verbal consent.