"Hospital policy on copying letters to patients"

About: The Royal Marsden Hospital (London)

(as the patient),

I am a patient at the Royal Marsden and am grateful and most impressed with how my difficult case is being handled.

What I am greatly less impressed with, however, is the hospital policy that requires patients to "opt in" to receive clinic letters.....and fails to explicitly tell patient this.

I only found this out when I made an inquiry and to my chagrin and surprised to find that a letter had gone to my GP and I had not been copied in to it. I don't have a GP who I see regularly and with whom I have any meaningful relationship with and I suspect that goes for an increasing number of patients.

In every other hospital I have attended I have found that patients are routinely copied into letters and have to opt out if they don't want to receive them. This is a much better policy and a step along the line to what should be full sharing of all the information in the medical record. This is the route to improved health literacy, reduced error and real partnership with patients. How can decisions be shared if you don't have access to the information on which these decision are being made?

I my view the Marsden's policy should be changed. Its paternalistic, out of step with current practice in other UK hospitals, and seems particularly regrettable given that the decisions on oncology patients are often high stakes ones, and the benefits, risks and harms of treatment need to be fully understood by patients so they can make an informed choice about best management, which aligns with their priorities and preferences.

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Response from The Royal Marsden Hospital (London)

We are sorry that you have not been receiving copies of letters when you would like to.

We ask all patients whether they would like copies of their letters at first registration.

We are sorry that the choice was not made clear to you when you first registered with us.

If a patient changes their mind about being copied into their letters at any time, they can let either Outpatients Reception or their Consultant’s medical secretary know their decision, and it can be amended on their records. The referring medical practitioner and the GP are copied in routinely to ensure they have the most up to date clinical information which may be relevant for other aspects of care.

Thank you for your suggestion regarding an automatic opt in to copies of letters. As a result of your feedback we have scheduled to discuss this change with our Patient and Carers Advisory Group.

We aim to ensure that our information leaflets on copying patients in to correspondence are available at Registration and Outpatients’ Reception.

We will review this to ensure the information is clearly displayed in these areas.

Please contact the Help Centre on 0800 783 7176 if you would like us to copy you in to future correspondence and to discuss this issue further.

  • Cinders thinks this response is helpful
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