2. Putting people at the centre of communication Dr Stewart Lambie Raigmore Hospital, Inverness

3. Wordle

4. Supported by Dept of Health 2003 – “…all letters that help to improve a patient’s understanding of their health and the care they are receiving should be copied to them as of right.” General Medical Council: Good Medical Practice – You must give patients the information they want or need to know in a way they can understand. – You must work in partnership with patients, sharing with them the information they will need to make decisions about their care

5. Caldicott two All communications between different health and social care teams should be copied to the patient or service user — there should be ‘no surprises’ for the patient as to who a record has been shared with.

6. Evidence-based Greater patient understanding and involvement Considered “helpful” or “useful” by patients Reduced inaccuracies Increased trust, communication and relationships Shared knowledge, more control Relieves anxiety Reminder of discussion and decisions Acceptance of bad news, share with relatives

7. Listening to patients in Raigmore Four renal consultants One copies letters, others don’t (didn’t!) 26 patients no copy – 22 would like one 32 patients had a copy

11. 50 Reasons Not To Change

12. Other reasons not to change Financial cost Green cost Confusion/jargon Confidentiality Upsetting Quality of consultation Quality of letter Judgemental terms

13. What worked with colleagues? Local champion Individual approach Small scale tests of change – 1 patient – 1 clinic Making it easy/hearing the patient voice – Request on front of notes

14. Person-centred care needs patients to receive copies of letters about them Improvement Methodology works for spreading good practice