2

Patient-focused correspondence

Paterson Inquiry · Report of the Independent Inquiry into the Issues raised by Paterson · Issued 4 February 2020 · Addressed to: Department of Health and Social Care

Government responseDepartment of Health and Social Care: Accepted (Dec 2021)

DeliveryDepartment of Health and Social Care says in progress (Jul 2026)DHSC and NHS England say in progress (Feb 2026)DHSC states no delivery position (May 2024)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

We recommend that it should be standard practice that consultants in both the NHS and the independent sector should write to patients, outlining their condition and treatment, in simple language, and copy this letter to the patient's GP, rather than writing to the GP and sending a copy to the patient.

Paterson Inquiry, Report of the Independent Inquiry into the Issues raised by Paterson · 4 Feb 2020 Source PDF →

Published evidence summary

AI-generated evidence summary

In July 2026, Baroness Merron, Parliamentary Under-Secretary at the Department of Health and Social Care, stated that the NHS Standard Contract requires outpatient letters to follow Professional Record Standards Body guidance to write directly to patients, and that private providers must send letters detailing costs and procedures under a Competition and Markets Authority order (Baroness Merron, Jul 2026). In February 2026, the Thirlwall Inquiry legal team noted that guidance was published in 2018 and 2021, and recorded that exploring how to monitor progress and make the process easier for professionals remained to be done (The Thirlwall Inquiry legal team, Feb 2026).

AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026.

About this summary
This recommendation applies across many organisations. The record above reflects central policy activity; adoption in individual organisations may vary.

Government response

●Department of Health and Social Care · Accepted · 16 Dec 2021

Words of: Department of Health and Social Care, Government response to the independent inquiry report into the issues raised by former surgeon Ian Paterson, 16 December 2021

Accept

Guidance across the healthcare system now states that consultants should write directly to patients and in a way they understand. Key stakeholders have committed to writing to their members to encourage uptake.

Over the next 12 months, we will explore with providers how their systems can change to make the process of writing to patients easier for healthcare professionals and how this can be monitored.

The government accepts this recommendation in full and agrees that the language used by consultants when writing to patients should always be accessible.

Extract from: Government response to the independent inquiry report into the issues raised by former surgeon Ian Paterson

Delivery

●Department of Health and Social Care says in progress · 16 Jul 2026

In October 2021, the Professional Record Standards Body (PRSB) updated its guidance on standard outpatient letters to make it clear that it is best practice for most outpatient letters to be written directly to the patient. The NHS Standard Contract states that outpatient letters should be consistent with PRSB’s standards. All National Health Service and independent sector providers are regulated by the Care Quality Commission, and assessments include how services ensure that patients understand and are involved in decisions regarding their care. As per the Competition and Markets Authority’s Order, private healthcare providers must send letters to patients prior to consultations or further tests and treatments setting out the costs, reasons, and other relevant information regarding the procedure.

From: Patients: Safety (written question UIN HL1746)

Site note: Baroness Merron answered HL1746, HL1747 and HL1748 together on 16 July 2026. HL1746 asks about compliance with this recommendation, and the row holds the answer's first paragraph, which is on it. The answer's later paragraphs are on the Paterson Inquiry Response Programme Board and on the recommendations as a group.

●DHSC and NHS England say in progress · 27 Feb 2026

The Hospital Discharge Service policy and operating model (August 2020) details the discharge requirements for all NHS trusts, community interest companies, private care providers of acute community beds and community health services and social care staff in England. It is published by the Department of Health and Social Care. The guidance, based on successful discharge to assess principles, aims to ensure that all individuals are discharged from hospital in a safe, appropriate and timely way. It includes patient information leaflets for a variety of different circumstances, as well as staff action cards summarising the responsibilities of health and care staff in the hospital discharge process.

Professional Guidance

In 2018, the Academy of Medical Royal Colleges (AoMRC) published guidance which states that letters should be written directly to patients, copying their GP (and provides a template). The AoMRC’s guidance is also reflected in National Institute for Health and Care Excellence (NICE) guidance on shared decision making.

In December 2021, the AoMRC, the Professional Record Standards Body (PRSB) and NHS Employers wrote to their members to remind them of best practice when writing to patients, referring to AoMRC’s guidance. In October 2021, the PRSB updated its guidance on standard outpatient letters to make it clear that it is best practice for most outpatient letters to be written directly to the patient.

The GMC updated its Good Medical Practice guidance to include communicating effectively with patients. This came into effect in January 2024.

Regulation

The NHS Standard Contract states that outpatient letters should be consistent with PRSB’s standards. All NHS and Independent Sector providers are regulated by the Care Quality Commission (CQC), and assessments include how services ensure that patients understand and are involved in decisions regarding their care. As per the Competition and Markets Authority’s (CMA) Order, private healthcare providers must send letters to patients prior to consultations or further tests and treatments setting out the costs, reasons and other relevant information regarding the procedure.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented – Ongoing”. Table row: section 29.2 No. P1 / Action 1.2, PDF page 740.

●DHSC states no delivery position · 15 May 2024

Action 1.2

In 2018, the Academy of Medical Royal Colleges (AoMRC) published guidance which states that letters should be written directly to patients, copying their GP (and provides a template). In December 2021, the AoMRC, the Professional Record Standards Body (PRSB) and NHSE wrote to their members to remind them of best practice when writing to patients, referring to AoMRC’s guidance. In October 2021, the PRSB updated its guidance on standard outpatient letters to make it clear that it is best practice for most outpatient letters to be written directly to the patient. The NHS Standard Contract states that outpatient letters should be consistent with PRSB’s standards. The AoMRC’s guidance is also reflected in NICE guidance on shared decision making. All NHS and Independent Sector (IS) providers are regulated by CQC and assessments include how services ensure that patients understand and are involved in decisions regarding their care. As per the Competition and Markets Authority’s (CMA) Order, private healthcare providers must send letters to patients prior to consultations or further tests and treatments setting out the costs, reasons and other relevant information regarding the procedure. The GMC updated its Good Medical Practice guidance to include communicating effectively with patients, which came into effect in January 2024.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024), The Department of Health and Social Care

Site note: DHSC's own comments on progress, supplied to the Thirlwall Inquiry in February 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). They are not a finding of the Inquiry. Table row: section 26.2 No. P1 / Action 1.1, 1.2, 1.3, PDF page 729-735.

Earlier statements on delivery (0)

●Department of Health and Social Care · 15 Dec 2022

In December 2021, the AoMRC, PRSB, IHPN and NHSE wrote to their members to remind them of best practice in writing letters to patients, pointing to the AoMRC’s Please, write to me: writing outpatient clinic letters to patients guidance.

Independent practitioners must, as per the CMA order, send letters to patients prior to consultations or further tests and/or treatments setting out:

costs

reason for the procedure

other relevant information

NHSE will consider a project plan to drive culture change in this area, dependent on availability of appropriate resource.

Communicating effectively has been incorporated into the GMC review of Good medical practice. Updated guidance is due to be published in early 2023.

From: Government response to the independent inquiry report into the issues raised by former surgeon Ian Paterson: 12-month implementation progress update

●Department of Health and Social Care · 23 Mar 2021

NHS England and NHS Improvement will examine how current guidance published by the Academy of Medical Royal Colleges (AoMRC) in 2018 on writing outpatient clinical letters addressed to patients (and copied to their GP) using simple, appropriate language can be incorporated into the requirements of the NHS standard contract.

From: Update on the Government's response to the Independent Inquiry into the Issues raised by Paterson (written statement HCWS869)

Site note: Written statement HCWS869 of 23 March 2021, made by Nadine Dorries, Minister of State for Patient Safety, Suicide Prevention and Mental Health, for the Department of Health and Social Care. It prints this recommendation and gives this passage under it.

What other bodies have found

In their own words. These do not change the delivery statement above.

●Thirlwall Inquiry legal team · 27 Feb 2026

Action 1.2:

Accepted by the government.

Guidance was published in 2018 and 2021 stating that consultants should write directly to patients in a way they understand.

The next 12 months will explore how to make the process of writing to patients easier for professionals and how to monitor this.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 29.2 No. P1 / Action 1.2, PDF page 740.

Earlier findings (1)

●Thirlwall Inquiry legal team · 15 May 2024

Action 1.2:

Accepted by the government.

Guidance was published in 2018 and 2021 stating that consultants should write directly to patients in a way they understand.

The next 12 months will explore how to make the process of writing to patients easier for professionals and how to monitor this.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 26.2 No. P1 / Action 1.1, 1.2, 1.3, PDF page 729-735.

How this page is built

The recommendation and the government responses are verbatim from primary documents. Delivery statements and other bodies' findings are shown in their own words, each with its source. The summary is written by this site and labelled as such. The Index does not paraphrase sources or characterise intent; it records what has been published.