Online requests, replies and attachments

Online messaging carries the same clinical risk and confidentiality issues as other contacts. Requests, replies, photos, documents and attachments can contain urgent symptoms, safeguarding concerns, identity information or other sensitive material.

Online requests still need safe handling

Patients may use online messaging because they cannot get through by phone, are embarrassed, have limited English, fear being overheard, or expect a quicker response. Staff should identify the practical request and also look for signs of urgency, unsafe contact, third-party involvement or safeguarding risks.

Do not assume an online request is routine. Messages about chest pain, self-harm, pregnancy bleeding, a very unwell child, or someone being unsafe at home must follow the local urgent process.

Be careful with attachments

• Check whether the attachment is expected before opening when local policy requires caution.
• Do not download files to personal devices or store them outside approved systems.
• Consider dignity and sensitivity for intimate images or safeguarding material.
• Record what was received and the actions taken without copying unnecessary detail into visible notes.

An online message should be routed by its content and risk, not by the fact it arrived digitally.

Digital records detail