Psychiatric Bulletin (2004) 28: 458. doi: 10.1192/pb.28.12.458-a
© 2004 The Royal College of Psychiatrists
Psychiatric Bulletin (2004) 28: 458
© 2004 The Royal College of Psychiatrists
Copies of letters to GP sent to patients
R. M. Wrate
49 Morningside Park, Edinburgh EH10 5EZ
Recent articles in the Bulletin suggest that there may be growing support
for this, both from within the profession and from patients (Lloyd,
Psychiatric Bulletin, February 2004, 28,
57-59). Survey data have
sometimes been based on attitudes towards a practice they had not yet been
exposed to (Dale et al, Psychiatric Bulletin, June 2004,
28,199-200), which may at
least partially explain respondents’ relatively low preference for the
psychiatrist’s GP ‘usual letter’, opting more often for a
‘separate simple’ letter, which these authors saw would also
safeguard ‘the professionalism of medical communication’.
Patients’ mental capacity to understand information and respond to it
appropriately were considered important issues, so extending the practice to
child and adolescent psychiatry might be expected to prove problematic.
In fact, I found that this proved not to be difficult over the course of a
recent 12-month locum post. Concerned that I was undertaking locum consultant
responsibility on a part-time basis, in a region distant from my own home
where no other psychiatrist specialist was in post, but unaware of the NHS
Plan (2000) that all patients should receive such correspondence by April
2004, I decided to copy all my correspondence with GPs to patients and their
patients, simply on the basis that such transparency might help facilitate
continuity of care in my absence. My patients varied in age from 5 to 16, and
in over 70 cases there were only two instances when problems arose. I decided
against sending one letter as I considered one mother’s well-being to be
too fragile to tolerate it; for another family, the detailed summary of
relevant history proved an overwhelming read.
Patients and their parents were otherwise uniformly appreciative. I also
discovered that when I sometimes sent out a completed letter, aware that I had
been unable to reduce a complex issue sufficiently for the child to readily
understand (and thus decide whether they agreed with it), their parent between
sessions had done so - sometimes in inspiring ways. I never sent patients
‘separate, simple’ letters. Instead they got the
‘usual’ letter, but one that always took me a bit longer to write
as I had recognised the challenge Lloyd & Roy (Psychiatric Bulletin,
January 2004, 28, 33-35)
have described. And Roy was right: the challenge in child and adolescent
psychiatry is far from insurmountable. But the ‘usual’ letter must
reach a high standard.
