Health Service Focus

11.10.17

Why don’t you write to your patients

Source: NHE Sep/Oct 17

The president of the Royal College of Surgeons (RCS), Professor Derek Alderson, talks about writing letters to patients with absolutely no ‘Surgspeak’ and the possibilities for advances in voice recognition technology to support this. NHE’s David Stevenson reports.

Advances in speech recognition technology are constantly being made, which could, eventually, lead to further benefits for the medical profession and the patients in their charge. Just before NHE went to press, for instance, Microsoft’s speech and dialogue research group revealed that its system had reached parity in conversational speech recognition. 

“Reaching human parity with an accuracy on par with humans has been a research goal for the last 25 years,” said Xuedong Huang, Technical Fellow at Microsoft. “Many research groups in industry and academia are doing great work in speech recognition, and our own work has greatly benefitted from the community’s overall progress. 

“While achieving a 5.1%-word error rate on the Switchboard speech recognition task is a significant achievement, the speech research community still has many challenges to address, such as achieving human levels of recognition in noisy environments with distant microphones, in recognising accented speech, or speaking styles and languages for which only limited training data is available.”

Moving from recognising to understanding speech is the next major frontier for speech technology, added Huang. 

In a recent article for the RCS’s magazine ‘The Bulletin’, Professor Derek Alderson, who was elected the organisation’s president earlier in the year, reflected on his career and whether surgeons do or don’t write letters to their patients summarising the outpatient consultation – especially after a recent meeting where he listened to a renal physician, who for more than a decade has been writing letters to those in his care. 

“I had tried this in my early consultant career in the dark ages of the electronic typewriter. The patients liked it, my secretary did not mind typing twice the number of clinic letters, but I grew to hate the need to check and sign all of these letters,” explained Prof Alderson. “There was also the small matter of letters sent by trainees on my behalf that always strayed heavily into ‘Surgspeak’. I convinced myself that most patients did not really care anyway, so when I asked them about the letter (I mainly asked those patients whom I thought would not have read it), I got the answer I was looking for. I gave it up as a waste of my time.” 

But as life moves on, and with the advent of the digital revolution, he asked the question: why don’t we follow up an outpatient consultation with a letter to the patient, summarising that consultation in a language the reader can understand? Especially as the General Medical Council states that patients must be given the information they want or need to know in a way they can understand. 

Prof Alderson explained that he had asked around to a number of surgeons who are sending letters to patients, and found that “patients like this behaviour.” 

“It makes them feel that they are being treated as individuals. It clarifies what was actually said in a consultation. Patients seem not to be frightened or upset by content. If they don’t have the capacity to read it then a carer or family member will read it to them,” he explained. “Having to turn medical language into a more colloquial style could be educationally beneficial and might help surgeons to convey technical information in a better way during consultations.” 

There are inevitable objections to this, he accepted, and although another letter involves extra dictation, “improvements in voice recognition technology might overcome additional demands on technical services and using email might overcome the cost of postage”. 

Although some solutions will lead to confidentiality dilemmas, the RCS president asked: does a patient’s happiness to be informed in this way not override objections? 

“For those surgeons who do write to their patients, I would like you to share your experiences and the feedback that you have received from patients,” he said. “If it’s a quality improvement then maybe it’s worth the investment in time.”

FOR MORE INFORMATION

W: www.rcseng.ac.uk 

Top Image: 

© NicoElNino

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

High Court rejects ‘hostile environment’ policy challenge from Windrush man who was refused cancer treatment

10/12/2018High Court rejects ‘hostile environment’ policy challenge from Windrush man who was refused cancer treatment

A member of the Windrush generation who was refused cancer treatment has lost a legal challenge against NHS regulations that make people who cann... more >
Nine out of 10 NHS trusts revealed to have asbestos in hospitals

10/12/2018Nine out of 10 NHS trusts revealed to have asbestos in hospitals

An investigation has found that nine out of 10 NHS trusts say they have hospitals containing asbestos. Of the 211 trusts who responded to FO... more >
‘Archaic’ and ‘absurd’ fax machines banned across the NHS

10/12/2018‘Archaic’ and ‘absurd’ fax machines banned across the NHS

The NHS has been banned from buying fax machines by the health secretary who has ordered a complete phase-out of the outdated machines by April 2... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >
681 149x260 NHE Subscribe button

the scalpel's daily blog

The good, the bad, and the potential of social media

05/12/2018The good, the bad, and the potential of social media

Vicki Nash, head of policy and campaigns at Mind, assesses the impact of social media on the nation’s wellbeing. Few days go by without a story in the press about the negative effect of social media on mental health. It seems obvious: people, especially children and young people, are often seen staring at their mobile phones rather than engaging with the world around them, while the news agenda is often dominated with stories of y... more >
read more blog posts from 'the scalpel' >

comment

Are we doing enough to accelerate self-care?

05/12/2018Are we doing enough to accelerate self-care?

Dr Selwyn Hodge, co-chair of the Self Care Forum, makes the case for the further reach of self-care, and for it to be embedded into our everyday ... more >
The future of commissioning

05/12/2018The future of commissioning

Julie Wood, chief executive of NHS Clinical Commissioners, reacts to Matt Hancock’s recent comments regarding commissioning. “Co... more >
Caroline Dinenage: Quality matters

05/12/2018Caroline Dinenage: Quality matters

Care minister Caroline Dinenage MP urges health and care organisations to achieve closer collaboration to improve the quality of care and support... more >
Technology first

05/12/2018Technology first

With the latest policy document from the Department of Health and Social Care (DHSC) heralding a new ‘technology-first’ ethos for the... more >
Prof Ted Baker: The State of Care

28/11/2018Prof Ted Baker: The State of Care

The CQC’s chief inspector of hospitals, Professor Ted Baker, discusses the findings of this year’s State of Care report and the need ... more >

interviews

How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >