Published: 13/05/2004, Volume II4, No. 5905 Page 20

I read with some interest HSJ's comment piece and director of patient and public involvement Harry Cayton's remarks about copying letters to patients and how 'some doctors do not want it' (news, pages 3-4; comment, page 17, 29 April).

This is no doubt true, but a lot of patients do not, either!

HSJ's leader and Mr Cayton seem to imply that primary care is at fault. As a professional executive committee chair who fully believes that the way forward is to make the NHS patient focused, I organised a pilot to study the impact of copying letters to patients within our primary care trust. Two practices engaged in the pilot.

They publicised patients' opportunity to receive copies of their letters, and made it clear in consultation that a copy would be provided.

In a survey prior to starting the pilot in one practice, 37 per cent of patients expressed an interest in having a copy letter. In the same practice, 180 letters were copied and made available for patients to collect (to ensure confidentiality was not breached). Of those, only three were picked up.

In the second practice, of 127 referrals made during the study period, 27 patients requested copies, of which 19 were collected.

Qualitative analysis during the study revealed that patients were far more interested in receiving copies of their hospital letters.

When the primary care consultation produces a referral letter, it is because the patient has initiated that process and the doctor is organising information provided by the patient into a referral.

Copying that back to the patient may be of value but, as discovered in our pilot, not many patients seem to think so.

GPs use a variety of approaches to communicate with patients (eg dictating the letter with the patient present so they can agree the content), adapting them to the individual circumstance.

Focusing on just one aspect of the GP consultation, and demeaning GPs for taking a pragmatic and sensible approach to the 300 million consultations they perform each year, yet again demonstrates that the innumerable critics of my colleagues still have little idea what GPs actually do.

I encourage and support colleagues to provide copies of letters to all patients who request them, but in the context of the many other duties they deliver on.

Martin McShane Professional executive chair North Eastern Derbyshire PCT