50. How Well are we Writing to Patients? A Review of Clinical Correspondence from a Tertiary Paediatric and Adolescent Gynaecology Centre

Background

It's recognised that patient engagement with healthcare is improved when letters are addressed and written directly to them. Adolescents and Young adults have different communication requirements; providing clinical communication with accessible language is thought to improve patient outcomes. Since 2018, clinicians in the UK have been advised to address all clinic letters directly to patients – this audit aimed to identify compliance with this national guidance.

Methods

A retrospective audit of outpatient clinic letters written to patients in January 2024, from a tertiary Paediatric and Adolescent gynaecology service, was undertaken. The clinical concern, patient age, learning needs, and who the letter was addressed to was recorded. For letters written to the patient, there was a subjective review of readability with assessment for presence of un-explained medical jargon and caculation of Flesch Reading Ease scores.

Results

There were 125 clinic consultations reviewed. The median patient age was 17 years old (2-51years). Clinical context varied and included 53/125 appointments about menstrual dysfunction, 27/125 mullerian anomalies, 20/125 Differences of Sex Development conditions and 10/125 vulval issues. The majority of letters were addressed directly to the patient (100/125 80%). The rest (25/125 20%) were addressed to the referring doctor. In 9/25 this was appropriate given a child's young age or a young person with learning needs. In 10/25 consultation notes were sent out as clinical correspondence, 5 consultations did not have a clinic letter for the appointment, and one letter was written directly to family doctor requesting referral to a service more local to the patient. Most letters written to patients were analysed subjectively to have recipient appropriate language (92%). Unexplained jargon included in letters included: contraindicated, hirsutism, malignant and laparoscopy. Flesch Reading Ease score was on average 51.5, which corresponds to being fairly difficult to read.

Conclusions

Generally, clinic letters were found to have good adherence to national guidance and addressed the patient. Although largely correspondence was written to patients was jargon free, objective assessment of Flesch Reading Ease score suggests that letters readability could be improved.