We have similar concerns regarding patients’ views of ward rounds to White & Karim (Psychiatric Bulletin, June 2005, 29, 207–209). Our service is a low secure forensic unit, which provides long-term rehabilitation in the West Midlands, and in contrast to general adult services in-patients have a 4-weekly ward round slot.

A recent review of records of 12 in-patients over a 6-month period highlighted that patient attendance at ward rounds has been poor – 2 patients attended frequently, 6 occasionally and 4 never. White & Karim fail to mention that standard nursing practice is to provide selective written and verbal feedback to patients after the ward round. Therefore the patients may feel that they do not need to attend as they receive comprehensive feedback without undergoing the ward round experience.

Hodgson et al (Psychiatric Bulletin, May 2005, 29, 171–173) stressed the compromise position of the ward round as it struggles to serve both professional and patient needs. The duties of a doctor according to the General Medical Council include the need to respect the rights of patients to be fully informed in decisions about their care, to give patients information in a way they can understand and to listen to patients. By maintaining the practice of ward rounds in which patients choose not to participate, are we failing to involve patients in decisions about their care? Patients want individual consultant time and ward rounds do not allow this. Perhaps the way forward is to have both a team meeting followed by individual patient time with a consultant.