Intended for healthcare professionals

Head To Head

Should patients be able to email their general practitioner?

BMJ 2014; 349 doi: (Published 02 September 2014) Cite this as: BMJ 2014;349:g5338
  1. Elinor Gunning, Health Education North Central and East London clinical teaching fellow1,
  2. Emma Richards, GP academic ST4 2
  1. 1Department of Primary Care and Population Health, UCL Medical School, London, UK
  2. 2Department of Primary Care and Public Health, Imperial College London, London, UK
  1. Correspondence to: E Gunning Elinor.Gunning{at}, E Richards emmalees{at}

Demand for better access to primary care is ever rising, but is email the answer? Elinor Gunning says that patients want it and that careful planning can mitigate worries about safety and security. Emma Richards is not so sure and thinks clearer guidance and resourcing are needed first

Yes— Elinor Gunning

The use of email services in primary care to consult on simple medical and administrative problems, and to facilitate follow-up and ongoing self care, has the potential to improve convenience for patients and efficiency for clinicians. Despite high patient demand suggested by descriptive studies, only 20-25% of doctors in Europe and the United States use email to communicate with patients.1 2 Within primary care use is variable; it is commonplace in Denmark but patchy in the UK. The 2014 UK general practice contract mandates online repeat prescription and appointment booking services.3 However, more extensive use of email is not obligatory despite it being endorsed by the Royal College of General Practitioners and the UK Department of Health.4 5

Those opposed to using email services in primary care often cite increased workload, concerns about patient safety and security, lack of proximity to the patient, and the effect on communication as the main barriers.1 I shared these concerns when I worked in a surgery that implemented email services during my training. However, I saw that with thoughtful planning email can benefit both patients and doctors.


The addition of email services has the potential to increase general practitioners’ workload, but if the service is well planned and managed then email can be a more efficient way to manage some routine conditions and requests than traditional methods. A 2012 Cochrane review found that the evidence on whether service efficiency and performance improved with the use of email was inconclusive.6 However, a …

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