Copying letters to patients--will it happen?

Protection Act 9 and the Access to Medical Records Act 10 all establish a right of access by individuals to reports relating to themselves provided by medical practitioners, and data about them. Access can only be denied where the information may cause serious harm to the physical or mental health condition of the patients or any other person, or where giving access would disclose information relating to or provided by a third person who had not consented to the disclosure. 2 Health professionals not wishing to copy letters to patients will apparently have to justify their reasons for withholding that information—patients will be able to complain to the Secretary of State if the policy is not being adhered to in specific practices and individual practices will be asked why they are failing to comply. 7 The international context sadly tells us nothing about copying letters— almost all the literature is from the UK and there does not appear to be any other country attempting to mandate copying letters in the way that the NHS Plan did. There is an argument that copying letters is beneficial for patients: the DoH guidelines 2 cite the benefits as more trust between patients and professionals, better informed patients, better decisions by patients about their treatment options, better compliance with taking medication or treatment, more accurate records, patients better prepared and less anxious. This is supported by an increasing body of empirical research, albeit from small studies. For example, views from patients and clinicians about copying GP letters to patients showed that in general, patients felt better informed about their illness and better prepared for their outpatient appointment. 11 However, support from a clinical perspective is more mixed. There are some notable enthusiasts; for example, Charles Essex, a paediatrician who regards copying letters as a matter of courtesy: " all that is needed is for professionals to treat patients with respect and treat other people in the way they themselves would like to be treated ". 12 There has been much concern about the resource implications: the time of doctors and secretarial/ administrative staff, the cost of paper, envelopes and stamps as well as time to deal with the additional enquiries from patients that seem to result. Data on how many clinicians already copy letters to patients appear to vary considerably depending on the source but some consider the resource implications to be worth the …