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Readability of out-patient letters copied to patients: can patients understand what is written about them?

  • S L Todhunter (a1), P J Clamp (a2), S Gillett (a3) and D D Pothier (a4)


The National Health Service Plan of 2000 proposed that patients should receive a copy of all correspondence regarding their care. There is concern that the readability of patients' letters may not be appropriate for many patients.

Materials and methods:

This study determined readability scores for sequential letters written to general practitioners and copied to patients, following ENT consultations at the Royal United Hospital in Bath. Intervention involved educating clinicians in techniques to improve readability.

Results and analysis:

A total of 295 letters from eight clinicians were assessed in the pre-intervention phase. The mean Flesch reading ease score was 61.8 (standard deviation 8.7) and the mean Flesch–Kincaid reading grade was 9.0 (standard deviation 1.7). Re-audit analysed a further 301 letters. There was no significant change in the readability of the letters post-intervention.


It may not be feasible to present medical information intended for general practitioners in a way that is readable to most of the UK adult population.


Corresponding author

Address for correspondence: Dr S L Todhunter, Royal United Hospital, Bath NHS Trust Combe Park, Bath BA1 3NG, UK. E-mail:


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Readability of out-patient letters copied to patients: can patients understand what is written about them?

  • S L Todhunter (a1), P J Clamp (a2), S Gillett (a3) and D D Pothier (a4)


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