Email

Before deciding on using emails as an alternative to a face-to-face consultation then you may wish to think about:

  • What exactly are you trying to achieve through using an alternative to a face-to-face consultation? 
  • Are you going to use a secure email system such as NHS mail, or a standard email system?
  • How will you ensure data security and confidentiality?
  • How will you record consultations in the notes?
  • Will email consultations be available to all your patients? How will you let them know?
  • Do you have clear agreed processes, agreed and understood by all staff?
  • What sort of problems do you plan to use email for, and how will you ensure patients use the system in this way?

Before introducing email as an alternative to a face to face consultation then you may wish to think about the following:

The choice of type of an alternative to a face-to-face consultation is dependent on your rationale for using an alternative to a face-to-face consultation. Is it for convenience for patients, improved patient access or to manage demand? It is also dependent on ensuring that the alternative to a face-to-face consultation(s) you have decided to introduce are suitable for your practice and its demographics. More information on who it is for and why can be found here. 

Practice set-up 

  • What will be the initial financial outlay?
  • Do you have sufficient infrastructure?
  • Will any additional calls be costed? (To call patients to discuss further or where the link has been lost)
  • Is this commercially driven? – Will you be using a commercial product?
  • Will you be using a standard email system or a bespoke secure system designed for health care such as NHS mail?
  • How will you record details of email consultations in the patients’ medical records?
  • Have all clinicians in the practice agreed to work in the same way?
  • Are there written protocols for both clinicians and administrative and reception staff?
  • Will the introduction require further staff training?
  • What will you do if the technology fails? – Produce detailed protocols for use
  • Will you require funding to inform patients of the changes?
  • What sort of consultations do you intend to manage by email and which should not be? 

Patient related 

  • Are there certain patient groups that will be disadvantaged? More information on who it is for can be found here.
  • Are you going to make email consulting available to all patients or just some? On what basis will you decide, and is this discriminatory?
  • How will you inform patients of the changes? – Possible options are; letters to patients, your practice website, flyers, banners in the practice, social media or word of mouth.
  • What do your patients feel about consulting by email? – Speaking to local representatives is key such as a patient participation group.
  • Is it more convenient for the patient? 

Benefits and Concerns

  • Are you anticipating that an email will be shorter/quicker than a face to face consultation? – will you monitor this?
  • What might be lost? – Accurate history, non-verbal cues, patient/doctor relationship
  • What might be gained? – Flexible working, more control over own workload, patients feeling more relaxed, further continuity of care, accessing patients who are otherwise unable to attend the practice.
  • How will you ensure that this does not become additional or hidden work? – Ensure scheduling and recording of the alternative to a face-to-face consultation.

Safety and Security

  • How will you ensure the security of email conversations?
  • How do you know the identity of the person you are communicating with, or who else might see you email?
  • Have you considered how you will ensure that patient confidentiality is maintained?
  • How will you ensure security of the patients’ details?
  • Are you using a secure system – such as NHSmail?

 We have provided some useful guidance below:

A list of companies that offer support for telephone consultations can be found here: