Communication with patients is vital in their management, and the NHS plan to copy clinic letters to patients was published in 2004. This study aims to determine whether patients are satisfied with their current communication or prefer alternative modes, overall and between different specialty clinics. A questionnaire was given to outpatients attending clinics in November to December 2006. A total of 483 patients returned the questionnaire, giving a 95 per cent response rate. Overall, 85 per cent of patients were satisfied with the current method of communication, and a significant number did want a copy of GP letters. Trend analysis suggests that, as the number of clinic visits increased, requests for copies of letters decreased (p = 0.02). Paediatric and psychiatric patients were more likely to want letters than medical and surgical patients (p = 0.003). Thus communication needs may differ between departments. Opt-in letter copy systems seem preferable.