Copying letters to older people in mental health services - policy with unfulfilled potential

The important initiative from the Department of Health (Working Group on Copying Letters to Patients, 2002) to require that letters between clinicians should be copied to the patient has not been implemented as widely as was intended. There have been concerns about logistics and fears that patients might be confused or frightened by communications they are not equipped to understand. Yet, modifications of the system to allow patients the choice to receive or not receive such letters and suitable training for clinicians offer safeguards. There is no doubt that copying letters provides an inexpensive mechanism for involving patients in their own care and treatment, offering transparency and confirming respect for equality in the relationship between patient and clinician. This paper reports experience with copying letters to patients and families with dementia. The process was warmly received by patients and carers, including families in a black and minority ethnic (BME) community, and few adverse comments were made. The routine application of this initiative will have benefits for the quality of service experience for older people, including those with dementia.