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GPs face 'huge burden' of copying in patients on all correspondence

GPs may be forced to copy patients in on all correspondence made on their behalf by practices under radical plans being considered by the Welsh government to improve patient safety.

The proposals follow an investigation into the death of Welsh schoolboy, Robbie Powell, that found a breakdown in communication between doctors and the patient had contributed to his death.

The review into the handling of patient records was launched on the 9th October and will consider 12 recommendations made by the Powell investigation earlier this year, including copying in patients, and the parents of children, to all correspondence about their care.

Pulse understands the review will also consider controversial plans to store GP records in such a way that they cannot be altered, moved or lost after a patient has died.

Ministers say the review is designed to improve communication with patients and the integration and safety of care, but GP leaders in Wales have branded the plans ‘insulting’ and unworkable.

Robbie Powell died 22 years ago, aged 10, after a series of errors meant the presence of Addison’s syndrome was not detected or treated.

The Welsh Government said the results of the review will be implemented in 2013/14, but in the meantime, all LHBs are ‘expected to ensure that processes are in place to handle any issues regarding the retrieval and handling of medical records following a patient’s death’.

A spokesperson said: ‘Robbie’s case raises some fundamental points which need to be addressed with a view to ensuring that they have been safeguarded against and adequately safeguarded.’

But Dr David Bailey, GPC Wales chair, said the suggestion that parents, guardians or adult patient should be copied into all correspondence made between clinicians, was a ‘non-starter’.

He said: ‘Copying patients into every correspondence between doctors would result in a huge administrative burden and would require a huge amount of funding.

‘I have nothing against patients being involved with discussions but it isn’t possible for every correspondence to be copied.’

Dr Bailey also described the plans to lock down records after a patient has died were ‘utterly insulting’.

He said: ‘IT systems are now highly sophisticated, with very clear audit trails. It isn’t possible to alter patient records without there being a indication that you have done so.’

Readers' comments (9)

  • My mum had terminal cancer & the fact that the consultant & GP copied us in on the correspondence really helped.

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  • Please put all this into perspective - about (22 x 300million) 6.6billion GP consultations have occurred since this one tragic event - you cannot change an entire system on the bases of such tiny figures.

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  • I don't mind copying patients into all the correspondances including blood tests and every trivial letter (including the one from our local counsellors about pt's appointment date) - as long as they are prepared to personally pay (not, not for NHS to burden as this invariably means cut in service some where else) for all the admin/postage fees.

    Just to put things into perspective, we recently debated if we should spend >£1000 on postage (not even admin fees!) for well men/women LES my local CCG is putting out. And that's just one letter of invitation for a 1/4 of our listed patients. I would imagine if we put all costs, a letter will cost around £2-3 (ink, paper, printer machine maintenance, envelope, admin time, postage, going to post office). I read about 150 letters/week so for my practice alone the cost would be (at £2/letter) over £70k/year - enough money to employ a salaried doctor of couple of full time practice nurses!

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  • Our profit per patient is £40.00 per year. Fantastic value. It is time to charge patients like other professionals do. The NHS will always want more for nothing.

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  • I imagine that it could be limited to patients with email addresses initially, allowing an electronic version to be sent, though no doubt that in itself is a form of discrimination in this world ! would eliminate postage costs but not staff time.

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  • Already done in private practice and even in some socialist countries and by some NHS consultants.
    If GPs copied their clinical notes entries to suitable patients it would help too. It is not necessarily that much more expensive to print in the office and hand out the copy to patient.
    Those who type quickly are at an advantage here.

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  • I think Helen Bright hasn't factored in the sheer volume of patients GPs see. I had (if you include telephon consultations) over 60 consultations yesterday alone. On average I have close to 200 consultations (again including telephone and some unscheduled chat with other professionals) per week.

    I cannot see how this would be "not too expensive" - even my time to copy, print and hand it over (bearing in mind some patient will want to read it there and then and will also ask for notes to be remedied) will result in loss of several consultations (e.g. if it took 10 seconds per patient - 10 x 200 = 33min, loss of at least 3 consultations per GP per week, so between all the GPs in my surgery 17 consultations lost (equivalent to my salaried GP's morning session) each week.

    Is that "not too expensive"? And I haven't even factored in the cost of stationary (printing out this many papers will not be inexpensive) yet............

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  • Helen Bright certainly does not sound like a real life jobbing GP or a doctor of any sort. Copies of letters for every trivial consultation would be irrelevant and wasteful. Not possible or helpful in terms of time lost, even if patients paid for it. Burden to everyone at the cost of actually seeing patients and getting some work done.

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  • So far, only costs have been identified. Would there be no cost savings?

    By avoiding the costs of 22 years of investigation into Robbie Powell's death. By patients perhaps understanding better what is happening? By avoidance of unnecessary investigations and procedures which a patient might identify before they take place?

    And perhaps there should be a charge? - But unless the option were required to be made available, I cannot see many doctors offering the service at all. Even with a charge.

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