Tessa Richards obituary

My friend Tessa Richards, who has died of cancer aged 75, was a doctor and medical editor who campaigned indomitably for patients to be partners equal with doctors in healthcare. In addition, she transformed the relationship that the BMJ (formerly the British Medical Journal), where she worked for 40 years, had with patients.

When Tessa graduated in medicine from Guy’s hospital medical school in London in 1973, doctors dominated patients, and did what they thought best for them. There was no culture of patients being equal partners, and doctors discussing options with them. As Tessa wrote in 1990: “Even the briefest spell on the other side of the desk or in a hospital bed gives blinding insight into patients’ vulnerability and of their need to be listened to, treated with respect, and given full, unhurried, jargon-free explanations.” Nor were patients involved in the planning of care, and in medical research they were subjects, not partners.

Tessa joined the BMJ as an assistant editor having worked for 10 years as a hospital doctor and a GP in London. When she arrived in 1983, patients might be pictured naked in the journal without their consent and with just a black band across their eyes intended to disguise their identity, a device that was later understood to be wholly ineffective.

By the time she left in 2023, the journal had a patient editor, a patient advisory board, and more than a thousand patient and public reviewers. Tessa led a strategy to incorporate patients into the journal and, crucially, ensured that it was implemented. Patients are now involved in all parts of the editorial process.

Over the years, Tessa wrote around 50 articles showing how health professionals working with patients as partners could improve patient outcomes and satisfaction and reduce costs. She worked tirelessly with others, and is widely recognised as a leader in patient partnership. Now patients are part of planning health policy, and work with health organisations such as the royal colleges; and the government’s research funding body, the National Institute for Health Research, requires that patients be included as partners in research.

In 2003 Tessa was diagnosed with adrenal cancer, a cancer that then commonly killed within a year. She underwent a major operation on her chest and abdomen and experienced massive blood loss. This experience turbocharged her passion for patient partnership.

Born in Tunbridge Wells, Kent, to Kenneth Richards, a farmer and film-maker, and Pamela (nee Knight), who became head of English at Benenden school, Tessa attended Bruton school for girls in Somerset and studied medicine at Leeds University before arriving at Guy’s.

In 1985 she married Charles Smallwood, a City solicitor, and they went on to have three children. Tessa was a keen tennis and squash player, enjoyed skiing, gardening and theatre, and was an inveterate traveller, taking any excuse to get on a plane to far-flung destinations, and visiting her brother, who lived in Colombia and Japan, several times.

She is survived by Charles and their children, Nick, Christo and Poppy, and granddaughter, Iniya, and by her brother, Christopher, and sister, Vivien.