Plain English Code for Outpatient Doctors

Peter Russell

September 04, 2018

Outpatient doctors should get into the habit of writing directly to the patients they have seen rather than forwarding them a copy of a letter to their GP, according to a new code of practice.

They should also avoid medical jargon and adopt 'plain English', the Academy of Medical Royal Colleges said.

'Please, Write to Me' Campaign

Outpatient clinic letters are the most-written letters in the NHS, reflecting the more than 5 million hospital outpatient visits each month in England.

The guidancePlease, Write To Me,  reports that clinicians who adopted a direct communication style said that they had become more 'patient-centred', and that GPs found the information more understandable and spent less time interpreting the contents for the patient.

It said outpatient letters should have three goals:

  • Record relevant facts about the patient's health and wellbeing

  • Present information in a way that improves understanding

  • Communicate a management plan to the patient and GP

Letters should be made more readable by removing redundant words such as 'actually' and 'really', using shorter sentences, and sticking to one topic per paragraph. If in doubt, doctors could use a tool like the Flesch reading ease test, the guidance said.

Avoiding Medical Jargon

Doctors are advised that although some medical terms may be unavoidable when describing a person's health problem and their diagnosis, these should be explained.

Examples of where plain English could be used in place of medical language were:

  • Kidney instead of renal

  • An irregular pulse instead of atrial fibrillation

  • Twice daily instead of the Latin 'bd'

Doctors are also urged to avoid using words that could stigmatise or offend. For example, saying 'you have diabetes' instead of 'you are a diabetic' was more acceptable.

Also, some medical terms could be easily misinterpreted. For instance, 'chronic' was often taken to mean 'really bad' rather than 'long-standing', the guidance said.

A Patient-Centred Approach

The code of practice has the backing of the Royal College of GPs. Vice-chair, Professor Kamila Hawthorne, said: "When we’re all so busy, it's easy to use language we're most familiar with as doctors, and other forms of short hand and jargon that might even be difficult for doctors working in one specialty to understand from doctors working in another, so for patients it could be really confusing.

"By hospital doctors writing any letters directly to patients, with their GP copied in so we are always aware of what is happening regarding our patient's care, it should make the process more patient-centred, and make them feel more involved in their care, which will be beneficial for everyone.

"However, it must result in a patient-centred letter that allows the patient to understand what has happened, what has been found, and what the future plan should be. I have seen a number of patients who have asked me to 'translate' the letter they have received from the hospital, which has been little more than a medical summary."

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