OA22 Co-designed resources to support rheumatology healthcare professionals to write clinic letters directly to patients: outputs from a UK mixed-methods study

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Abstract Background/Aims Our previous research found most UK rheumatology healthcare professionals (HCPs) write outpatient clinic letters to GPs rather than patients, contrary to national guidance. Most patients would prefer to be written to directly. Nearly half of HCPs would consider changing their practice, particularly with support. We aimed to identify how to support HCPs to write directly to patients and patients to engage with their letters. Methods A mixed-methods study involving surveys, qualitative interviews and three co-design workshops. UK adult rheumatology patients and HCPs were recruited from eight UK NHS/HSC sites, networks and social media in 2024-2025. Descriptive statistics and content analysis were used to summarise survey and interview data, which were presented during the workshops. Workshop discussions concerned the range, type and format of potential supportive resources. NHS ethical approval was gained. Results 705 patients responded to the survey, 16 were interviewed, and 13 joined one or more workshops. 299 HCPs responded to the survey, 17 were interviewed, and 13 joined one or more workshops. Patients want medical language to be included in letters and explained in plain English, either within the text (e.g., in brackets) or through an accompanying glossary or ‘list of terms’. Some words could be upsetting/offensive and would ideally be avoided. Patients value letters that are short and easy to understand, contain clear advice on when and how to seek help, and list actions for themselves, their GP and rheumatology team. HCPs and patients agreed some patients might need encouragement to engage with letters, via a leaflet and/or their clinician. HCPs were apprehensive about changing practice. Example paragraphs and explanations of terms could help them start writing to patients. A patient feedback tool could also provide reassurance and help improve practice. HCP resources include guidance about letter content and structure; a script for discussing letters with patients; a phrasebook; example paragraphs, and a patient feedback form with instructions and a summary form. Resources for patients include a leaflet about clinic letters and a ‘list of terms’. Complementary resources were designed to address each groups’ respective needs. For example, the HCP phrasebook is structured alphabetically within categories; whilst the patient ‘list of terms’ is entirely alphabetical, with icons to indicate category. Conclusion HCPs need support to write clinic letters to patients, and patients need support to engage with letters. We collaboratively designed and have developed resources to meet these needs and encourage direct letter writing and patient engagement. Resources, which will be publicly available, include guidance, phrasebooks, example letters and patient feedback tools for HCPs, together with a glossary and information for patients. Future work will focus on refining, implementing and evaluating these resources at scale, including perspectives from primary care. Disclosure R. Goulding: None. B. McMillan: None. E. MacPhie: None. K. Staniland: None. W. Dixon: None. W.J. Gregory: Consultancies; W.J.G has received honoraria for speaking and advisory board participation from Abbvie, Novartis, Pfizer, Sobi and UCB, unrelated to this project. J. Firth: None. C.A. Sharp: Grants/research support; This work was funded by the British Society for Rheumatology and the author would like to thank the Society for its help and support., This work was also funded by the Centre for Epidemiology Versus Arthritis, and the author is grateful for their help and support.

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