Intended for healthcare professionals


Patients should receive copies of letters and summaries

BMJ 2002; 325 doi: (Published 17 August 2002) Cite this as: BMJ 2002;325:388
  1. Cyril Chantler, senior associate,
  2. James Johnson, chairman, Joint Consultants Committee
  1. King's Fund, London W1G 0AN
  2. BMA, London WC1H 9JP

    EDITOR—In 2000 we attended a meeting to discuss how to improve healthcare delivery within the NHS.1 One of the recommendations was that patients, except in special circumstances, should receive copies of all letters, case summaries, or care plans written by doctors or other clinicians. We also suggested that with the patient's approval such material should be stored on a central server. The suggestion was accepted and published in the NHS Plan. The perceived advantages were threefold.

    Firstly, patients have a right to know what is being written about them and, if such 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 on confidentiality. An electronic health and medical record is vital if we are to develop an integrated NHS.

    Secondly, to refuse to provide such information if this is the patient's wish is to deny their autonomy.

    Thirdly, patients are often anonymous when they become acutely ill because their history is unknown to the doctor or clinician who sees them in primary care or when they are admitted to hospital. Access to a summary record either carried by the patient or through the electronic record, would overcome this difficulty.

    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.2 The proposal was approved by the Joint Consultants Committee subject to certain safeguards. We assumed that recommendations from the profession and the Department of Health would follow and the practice would be introduced throughout the NHS without delay.

    Not so. We have learnt recently that a committee set up under the NHS Modernisation Board has now recommended further research.3 Given the urgency of developing electronic medical and health 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.


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