This article reports on the development and piloting of a patient held record for adult mental health users. Development of the format and content of the record was determined in consultation with a user group. Piloting and subsequent evaluation of the record with users revealed a number of issues which need to be addressed in the promotion of a patient held record.

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Fees for completing attendance allowance reports SIR,-Dr Christopher Law asks how many reports are requested of doctors and why arrangements exist for such reports to be paid for outside NHS remuneration.' The answer to the first question is, "All to many!" General practitioners in particular receive a myriad of requests for reports, some of doubtful necessity. In regard to the second question, there is no doubt that the requirement to pay for these reports on an item of service basis is responsible for preventing even more requests for reports. Moreover, in these days of cross charging between all government departments it would be invidious for general practitioners, who are independent contractors, or indeed hospital doctors, who are salaried to the NHS, to be asked to subsidise a department outside the NHS. With regard to completion of the report for patients claiming attendance allowance under the new "special rules," the fee agreed with the Department of Social Security takes into account those patients whose records take much longer to examine before the form can be completed.