A queue nobody can see
After a clinic, consultants dictate letters. Some are typed within days. Others sit in the queue while secretaries cover reception. Typed letters wait for the consultant to review and sign. Signed letters are printed and posted, or emailed to a practice's generic address. Weeks later, a GP rings to ask what happened to their patient.
The backlog is real but invisible: dictations in one system, drafts in a folder, sign-off in an inbox.
Why letters back up
- Every letter is typed from scratch, even when most of it is standard.
- Dictation, drafts and sign-off live in different places.
- Clinicians approve letters in batches when they have time.
- Sending to practices is manual, by post or email.
- Nobody can see the age of each letter in the queue.
End-of-treatment summaries are the easiest to forget. They are not tied to a clinic appointment, so there is no natural moment when a secretary is prompted to start one. A patient can finish treatment, move on, and their GP never receives a summary unless someone happens to remember.
What the backlog costs
GPs are left without information about their patients. Referrers who do not hear back may refer elsewhere. Secretaries feel constantly behind, and clinicians face a large pile of letters to sign at once.
| Stage | Today | With a letter pipeline |
|---|---|---|
| Dictation | Audio files in a system | Linked to the patient and appointment |
| Drafting | Typed from scratch | Drafted from dictation and structured data for editing |
| Sign-off | Pile of printouts or emails | Queue per clinician with ages shown |
| Sending | Print and post | Electronic delivery where the practice accepts it |
It also affects funded patients. Where a GP or commissioner expects to hear about a funded patient's progress, a late letter can lead to questions, repeated requests and delays in any follow-on referral the patient needs.
How we build it
- Letters are created as tasks linked to the appointment in your clinic management system.
- Standard sections, such as patient details, referrer and appointment facts, are filled from structured data.
- Dictation is transcribed by a speech-to-text service and inserted into the draft for the secretary to correct. Clinical content comes only from the clinician's dictation.
- Each clinician has a sign-off queue on screen, showing how long each letter has waited.
- Approved letters are sent by the electronic route the practice accepts, or printed for post, with delivery recorded.
- A dashboard shows the backlog by stage and age.
No letter is sent without clinician approval. Transcription and templates speed up the typing, but the content remains the clinician's.
We also set rules for when letters are due. A consultation creates a letter task straight away. The end of a treatment episode, recorded in your clinic management system, creates a summary letter task. Each has a target date your clinic chooses, and the dashboard shows which are approaching or past it.
What your secretaries and consultants get
Secretaries correct drafts rather than type from scratch. Consultants sign off on a screen with the oldest letters first. Managers can see the backlog and act before GPs complain.
GPs receive letters by a route they can process, and the clinic has a record of when each was sent. When a practice says a letter never arrived, you can see exactly when and how it went, and resend it in a moment rather than hunting for the file.
Is your letter queue like this?
- GPs ring to chase letters about their patients.
- Letters are typed from scratch.
- Signed letters wait to be posted.
- Nobody knows how many letters are outstanding.
- Clinicians sign in large batches.