If you have a concern about a patient letter, you can refer back to the original, a copy of which should be filed in the patient's notes.

Hospitals may wish to consider adding a watermark stating 'patient copy' to the letter that is sent to the patient. Doctors should also bear in mind that electronic signatures can be copied.

The MDU has become aware of an instance of a patient using advanced editing tools to alter the content of a hospital fertility clinic letter to her GP. The patient then used the modified letter to try to influence another NHS doctor to secure further tests.

Fortunately, the second doctor became suspicious about the nature of tests recommended and asked the original author to review the document.

MDU advice

There is no reason to suggest that this might be the start of a trend. However, it is absolutely right that, for the sake of transparency, the patient receives a copy of their clinic letter.