BMJ 1994; 309 doi: (Published 24 December 1994) Cite this as: BMJ 1994;309:1736
  1. Hilary Jackson

    We have just spent six months sorting mail. Not a usual sort of task for librarians you might think, though I could tell you about jump leads, screwdrivers, and electric cables, but that is another story.

    I had been making some inquiries about where the junior doctors' post went. Discovering that no one was really sure, including some of the doctors, I took an executive decision. The library staff now deal with it.

    Did you know that there is an NHS equivalent of the Bermuda Triangle? It is called hospital mail.

    Looking at as many research papers as I do, I have often come across references to poor response rates to surveys despite persistent postal (my italics) follow up. The authors speculate about the reasons but none of them seem to have considered one of the obvious ones. They haven't seen the paperwork yet.

    I have just read an article in the magazine Fundholding called “Preventing delays to referral letters,” which monitored the time it took a notification of appointment to arrive at the surgery from the date despatched from the surgery. The maximum delay was 26 days. The reaction of the hospital concerned has been to set up a “new department to ensure that incoming mail is organised, allocated and distributed properly.” (I bet that it is not the library staff doing it out of the goodness of their hearts. Someone will be paying out to have it looked at.) Well, the practice is fundholding so it's in the hospital's interest to look into it.

    I have read items commenting on the difficulty of persuading people to change their practice when new research published in some prominent journal has proved the efficacy of a new method. My theory is that they won't have read it yet. It will be addressed to them at their previous job, if not the one before that.

    This past six months has been a revelation. For example, we have discovered a whole underworld of doctors we never knew we had, who don't collect their mail from the designated pigeon holes anyway: associate specialists, clinical assistants, clinical attachments, consultants who just do one session a week, hospital practitioners, locums, medical students, and general practitioners. Then there is the mail for people who left two years ago and all the other stuff that the post room does not know what to do with. And hospital departments ask us to distribute memos “to all the doctors please” as though it was a nice straightforward task. My staff and I have met more new doctors looking for their pay slips than have registered to use the library.

    Are we still sane? Have my staff mutinied? Does the library still function as the library? Do literature searches get done and books get ordered? Well, yes they do. But why do we put up with it? Because the juniors think it's wonderful; apparently they had been complaining for years. As the pigeon holes are now in the foyer of the education centre opposite the library, the postgraduate centre staff now see most of the juniors regularly when they collect their mail. The library got a lot of brownie points for doing it. The thought of going back to the absolute hell it was before is too horrific to contemplate. And, finally, the library staff now know that everyone gets their overdue book reminders— which is, after all, what started it all off in the first place.

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