Easing pressure with mail triage

Mail-triageDr Kari Nightingale, GP and previous Health Education England Fellow, Wessex


The project aimed to enable GPs to attend more promptly to patient matters specifically requiring GP action.


Increasing pressures on GP time may lead to delays in dealing with clinical matters or administrative tasks.

Project design

Our strategy was to change the previous system in which the majority of incoming correspondence was sent to GPs regardless of content. We designed a process whereby non-clinical staff could deal with incoming mail that does not need to be seen by GPs.

Changes made

Using a protocol developed from feedback from GPs during initial data collection, the scanners route each scanned document according to an agreed protocol.  A safety net remains in that an IT and Data Quality Administrator (“IDQA”) checks the scanners’ decisions by reviewing the items not sent to GPs.


Volume measurement:


Table 1: Numbers of documents allocated by new routing process


A survey of GPs produced the following results:

100% strongly agreed that since the mail triage project started they had noticed a reduction in the number of mail items they received.

85% strongly agreed and 15% agreed that they could now deal more quickly with mail items requiring their attention.


GPs were asked for examples of how this new system has improved patient care:

“Able to keep on top of the work on a daily basis so letters responded to more quickly and new treatment or changes in treatment actioned more swiftly”

“Mail no longer waiting in our inbox for days (or weeks) to be actioned”


Message for readers

  • The new system successfully continues in the practice.
  • We used the NHS risk matrix [1] and the NHS Risk Management Policy [2] to assess risk and implement appropriate mitigation which includes regular audits and identifies appropriate team members.
  • The practice has had a CQC visit since implementation at which the project was presented and discussed and a report about the project submitted.  The practice has been rated “good” across the board.
  • Individual practices will have their own preferences for the mail items the GPs do or do not wish or need to see.  Practices may benefit from developing a protocol for directing items according to their own defined categories of mail.

Useful documents

If you would like more information on implementing this Bright Idea in your practice, please email bright.ideas@rcgp.org.uk

1. Risk Matrix from National Patient Safety Agency document “A risk matrix for risk managers”, 2008
2. NHS Risk Management Policy and Process Guide and Risk Matrix, 2015

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