A patient consulted her GP requesting a referral to a gynaecologist for a termination. She stated in the consultation that she did not want her husband to find out. The GP wrote a referral letter, which was placed in the “for collection” box in reception. For some reason the letter was not collected.
The patient then visited the surgery 3 months later to ask for a letter for the clerk at the Magistrates court, explaining that she could not attend court due to a medical reason. The GP had the letter typed and this was also placed in the box for collection.
The patient’s husband came into the surgery 3 days later to collect the letter to take to the Magistrates court but the wrong letter was given to him. The letter he was given was the one typed 3 months previously for the Gynaecologist.
The husband took the letter to the Magistrates Court. When the Court clerk opened the letter and found it was not for them she handed the open letter back to the husband who then read the letter.
There are several issues here – can you identify what could have happened and what action could have been taken to ensure that it does not happen again.
- All personal letters should be placed in a sealed envelope.
- Each envelope should be dated on the back of the envelope and the “collection box” should be checked on a monthly basis. Any letters that are over 4 weeks old should be opened and checked. If necessary a phone call to the patient to ask if they still need the letter, and according to their reply the necessary action taken
- Inform their GP that the letter has not been collected so they can follow this up.
- Enter on the patient’s records (or in a separate message log) that you have spoken to the patient about the letter and their response and the action that you have taken. Also remember to date and time the call.
- If the letter is not longer required remove the letter from the “collection box” and ensure that you have guidelines on what to do with it. Shred it, or other.
- If the letter is required and the patient is going to collect it cross off the first date and add the date you spoke to the patient on the back of the letter to avoid the same process happening again.
- If you go to the “collection box” and identify two letters there look at the dates on the back of the envelopes, check the patient’s records and see which date corresponds with the envelope. If you are unsure open and check the letter and place it in a new envelope. remembering to add the dates on the back again.
- In today’s society Patient Confidentiality is vital – we should be asking if we should have actually given such a letter over to her husband. Having it in a sealed envelope is definitely more secure than just handing over the letter without an envelope. So please ensure that all confidential letters are in sealed envelopes.
- 99% of the time it would be safe to hand over such a letter – but there is always that 1% that could backfire. But with everyone living such a busy life we always rely on family/friends helping out at such times. If you are in any doubt speak to your Supervisor/Manager or even phone the patient and ask if they are happy for you to give the letter to the person at the desk.
- The 1% of this backfiring could be that when her husband read the letter which was meant for the Gynaecologist it could have caused a big problem, especially as she had already said she did not want her husband knowing about the termination. This could have led to the surgery being sued for breach of confidentiality.
- Always think of the 1% and cover yourself as much as you can.
Does your practice have a policy on the collection of letters?