Category Archives: Nigel Mathers, Honorary Secretary of the Royal College of General Practitioners

C4CC welcomes new standards to be adopted for letters to outpatients

Hospital consultants will be encouraged to write clear, easy to understand and jargon-free letters directly to people and copied to their GPs, instead of the other way around, under proposals recently approved in principle by the Academy of Medical Royal Colleges (AoMRC) and championed by the Coalition for Collaborative Care (C4CC).

The AoMRC has been tasked with leading a programme of change to encourage and support clinicians across all disciplines to adopt this as good clinical practice and to incorporate it formally within the training curricula of both undergraduate and postgraduate doctors.

C4CC has long campaigned for this vital change, replacing the current practice of consultants writing to an outpatient’s GP, and referring to patients in the third person.

C4CC co-chair Nigel Mathers, the Honorary Secretary of the RCGP, said the plans had gained widespread support from doctors, including the Royal College of General Practitioners, and patient organisations.

“This will be a personal letter to you, with your GP copied in, who will also be supplied with more detailed technical information, which can also be discussed with you,” he said.

“It’s a big cultural change and naturally will take time to become standard practice because it requires training and a different way of thinking for all doctors, but the new policy framework is an important step in the right direction.”

Katie Clarke-Day, who works with NHS England and C4CC on projects to improve the lives of people, like her, with multiple long term conditions, said she had long advocated for more personalised communication between doctors and their patients.

“It may seem like a small change, but it is hugely important, particularly for people with long term conditions,” she said.

“It’s about relationship building with the people who are keeping you alive and trust is really important.

“From the start, from the very first letter that you receive, you should have all the information that you need, in plain English, so you can take ownership of your treatment and get the appropriate support,”

Making sure the right information is always included in outpatient letters is the first step.

New guidelines to help professionals do just that were published by the Professional Record Standards Body (PRSB) last summer.

Their new guidelines encourage professionals to produce consistently high quality letters.

“Many more people are treated in outpatient clinics including people with complex health and care needs so it is really important that outpatient letters are clearly written and contain the right information for hospital staff, GPs and teams looking after people in the community,” said Lorraine Foley, CEO of the PRSB.

“Our standards help professionals share information. We are right behind the proposals to ensure that letters to patients are written in plain English so that everyone has a good understanding of a person’s health needs and most importantly that patients can take greater control of their care.”

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We can help GPs find better way of working that will improve the lives of patients with long-term conditions

As a GP every day seems to bring new challenges. For example, 50 per cent of all our consultations are now taken up by people with long-term conditions and the complex problems presented by multimorbidity. Our consultation rates have been steadily increasing over the past decade and the consistent message from our patients is that they want better partnerships with us, particularly with those who have long-term conditions (half of the over 50s). So how can we meet these challenges?

One approach which has been shown to be effective is care planning – a process by which people have access to their test results and share decisions with their doctor about the key priorities for their future care. This approach was pioneered by the Year of Care Partnership and the RCGP.  However to implement care planning four things need to be in place.  First is a commitment to partnership working.  Second our patients (people with long-term conditions) need to be engaged and involved in the process. However, care planning is not possible without a further two other elements – the resources to support this change in the way we work with our patients and the necessary practice organisation required to ensure that patients receive their test results in the right way in the right time. These four components make up the House of Care.

A wide range of organisations are now committed to this new way of working and have come together to form the Coalition for Collaborative Care.  Our main objective is to transform the way we currently support people with long-term conditions by building the House of Care in every community.  We hope the synergy created by working together will help us to embed care planning and other initiatives designed to support self-management and share decisions with our patients into every day clinical care in the NHS.

We have a wide range of new ideas and innovations to help clinicians and patients implement this way of working which can bring about improvements in quality of our care as well as health outcomes.  The more people and organisations we have in the coalition the better and I hope to welcome many more to our number over the coming weeks and months.

Nigel Mathers, Honorary Secretary of the Royal College of General Practitioners and convening chair of the coalition