Email Management


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Author: Charlotte Davies / Editor: Liz Herrieven / Codes: / Published: 25/08/2020

Information overload is everywhere. With so many different methods of communicating, it is really easy for important facts to get lost in the noise. I think we all have a responsibility to make this better and easier, and I think we can make email work with a few changes.

But why email? What’s Up with WhatsApp?
We know that clinicians love WhatsApp, but I wonder how many people, like me, are losing their love for it due to COVID-19?

Whatsapp groups have long been advocated for communication in a major incident. COVID-19 caused, for many of us, a long-lasting, all encompassing, (mostly as yet undeclared at trust level) major incident, that I do not think WhatsApp should be used for.

Unlike other incidents, this critical event is prolonged and unfolding over many months. Well-being sources (even on WhatsApp!) advise us to limit our “work” time and to switch off electronic communication. For the privileged few who have work mobile phones connected to the “emergency” WhatsApp groups, this is relatively easy. For most of us though, it’s impossible. WhatsApp is the main method of communicating with our isolated friends and family, so ignoring those notifications is not easy.

You can mute individual groups, but then you run the risk of missing important information. Should a WhatsApp group on your personal phone be the only way of receiving new protocols and policies? I don’t think so.

So, I think the alternative is probably email, but switching off from email can also be difficult.

Team Slack-er?
Other communication platforms like “Slack” are available. The RCEMLearning team use Slack to communicate and it’s great. It segregates each bit of FOAMEd into its own channel and its easily mutable. It works on desktop and mobile. It’s free. The downside to using something like Slack for “regular work” is that, without discipline, its easy for it to become just another chaotic email alternative. Threads can get muddled. Emails still get sent. And there’s always one person who doesn’t want to use it! So I’m not sure Slack works for all circumstances.

Microsoft Teams…might be an alternative once the NHS has its subscription sorted!

There are lots of ways of managing your email inbox but the important thing is to find a system and stick to it. There’s some tips and things to consider. Your inbox won’t magically manage itself. It needs some input from you – and you need to decide what that input is, and make it work for you.

“Everything in life worth achieving requires practice. In fact, life itself is nothing more than one long practice session, an endless effort of refining our motions. When the proper mechanics of practicing are understood, the task of learning something new becomes a stress-free experience of joy and calmness, a process which settles all areas in your life and promotes proper perspective on all of life’s difficulties – Thomas Sterner”.

Ask yourself about these key areas:

How many email addresses to have? One email account or many? I like to segregate my work and personal emails into two accounts. But I also like to have a separate email account for each non-professional role eg. newsletter editor. This doesn’t work for everyone and some suggest that this just increases the number of capture locations: suddenly you’ve got five email inboxes to manage instead of just one.

When to check your email? Time slots – if you check your email every few hours, rather than constantly or every 30 minutes, it takes less time from your day. Just like the rest of your time, email time needs to be managed. “Indistractable” is a fab book that talks about the addictive nature of email and is worth a read.

How to organise your email?
Folders. I like folders, but they do mean more mouse clicks, and more time finding them, particularly as Outlook doesn’t seem to reliably sync with Outlook. Maybe that’s just me. Some people like labels, and there’s a great twitter thread on using labels from @VenkBellamkonda here.

Filters can easily be set up. I have a filter set up so all emails from our trust incident system go straight into an incident reports” folder, which means they’re tidy, but out of the way. To set up a filter in the NHSMail web app, log in to your email, click on the settings wheel on the top right hand corner, then click on “options”. Click on “organise mail” and then click the + to set up a new rule. If you want to set up an email address rule (eg. email from goes to trash), that email address book needs to be added to your email address box first.

Inbox Zero? Something we all aspire to. How to get there is often difficult. Firstly, attempt to reduce the number of emails you get. Unsubscribe from bulk mailing lists: not only will you make your inbox better, but you’ll save the carbon generation of each email. Answer emails – otherwise you’ll get ten chasing you up. Set some boundaries and talk to your team about communication and emails – when to copy you in to something, when not to.

Then try and answer, and deal with, your emails. Firstly, follow the “Dave Allen two-minute rule” – if an action will take less than two minutes, it should be done at the moment it’s defined – this includes filing “for reference” emails with no associated actions. Next prioritise activities. If it can be delegated to someone, delegate now – it takes less than two minutes, and is then done.

For everything else, you have options! Is it “aspirational” that you deal with this email? Maybe move it into an aspirational folder. Is it “essential”? Schedule a response in.

Oh, and when you’ve dealt with your email, file it or delete it. Once it’s out of your inbox, you know you’ve actioned it. Which means you won’t miss important new arrivals.

So now you’ve thought about how to manage the email once it’s arrived in your inbox, how can you help other people manage the emails you send?

Writing Email
Sending emails fit into three main categories. Forwarding, replying and writing! The general rules are the same for all – could a phone call or a face-to-face visit do the job better? Are you forwarding/sending in anger? Do you really need all those attachments (which contribute to a carbon footprint)? And don’t expect an instant reply. The Guardian suggests keeping emails to less than 80 words.


– Do I need to forward this email?

And if I do need to forward this email, how can I make it easier for people?
Can I delete the trail of forwarded emails or summarise the attachment so that people know what they are reading without scrolling for ages? Especially on mobile devices, scrolling down down down down past the list of “please forward” “please forward” before you get to the “meat” of the email is really frustrating!
This question will be easier to answer if you’ve had a communications chat around emails with your team.

  • Should recipients be blind copied?
    Blind copy (BCC) is great for protecting personal details, especially if there’s a long list of recipients, but if I blind copy the recipients, how does everyone know who has had the email? If you blind copy, indicate who has received it by saying “Dear South London Higher Trainees” or “Dear Supervisors”, so people know – and don’t forward again.
  • Do I need to reply, or reply all to this email?
    Many of us reply to say “I acknowledge what you’ve said”. But that’s not always needed. And sometimes its better to wait and consider before sending a response – and see what unfolds whilst you’re waiting.

– Writing Emails

If you’ve decided you do need to write an email, make all your words count. The subject needs to be relevant – especially as people may search for your email by subject. It needs to be short enough that its not cut off on a smart-phone screen.

Make your email content punchy. One framework is the “SCRAP” framework (from emphasis training). They advocate structuring your email into a situation, a complication, a resolution, an action and politeness. In that order it’s powerful. It takes me longer to write emails like this, but I think it means I think about the content a lot more carefully.

Attachments should be carefully considered. Big attachments have a huge carbon content, are more likely to be deleted by the recipient when their inbox is full and less likely to be opened on a mobile device. Do you need the attachment or could you send a file link instead?

Should this email be sent now, or should it be saved and collated into a daily digest?

These tips are collated into a nice summary from HBR on “compassionate email”.

Hopefully this will make you think about how you receive and send your email. Tell us how you manage your email inbox – here are a few thoughts to get you going!

Charlotte Davies, EM Consultant

I like order in my email inbox. I check my personal email on my phone, but work is always from a desktop. I skim read the emails, delete the irrelevant, reply to the quick wins, and then process the longer emails. I do put some in folders for information. I try to move the pending emails onto my “to action” trello to-do list. If my email inbox gets out of control, I read emails, then move them into “action later” folders, and empty my inbox. I then move all of “action later” into my inbox and go again!

Liz Herrieven, EM Consultant.

I’ve turned off the notifications for emails on my phone so I’m not tempted to open up the app whenever I get a new email. When I do take a look I action or reply to any quick ones there and then but flag any others for later. Once sorted, those I need to keep go into folders. Everything else is deleted. I like a good “Unsubscribe” link, too!

Duncan Brooke, EM Consultant, TPD EM Higher Training Programme, Academic Mentor LaSE Fellows in Urgent Care (ie gets lots of emails!).

Set a personal target – mine is <100 emails in my inbox. To stay in my inbox the message needs to be either:

a) need a reply
b) awaiting a reply from someone else before urgent action (less urgent actions are filed away awaiting a reply)
c) I expect to need to reference the contents in the “near” foreseeable future, e.g. meeting papers etc.

Everything else is either

a) deleted
b) answered (if required) & filed in a subfolder (I have many subfolders and subfolders of subfolders)

I check emails twice a day – usually at the beginning of the day to check for urgent overnight stuff and then once later in the day for a “proper session” to allow me action my inbox (& get below a 100!). Personally I find the desktop version of Outlook a dream – spend sometime setting up the autoarchive settings (not available on the web lite version I believe) and you never delete an email trail that you might conceivably need in the future but equally never blow your inbox size allowance. It also allows you to keep a handle on many subfolders by emptying ones you no longer use. One of my occasion admin jobs is to go through my subfolders deleting subfolders with no emails in them anymore (because they’ve all been auto archived). A perverse sort of pleasure I know.

Brookes law of annual leave – “it will take you twice as many days to sort out your inbox as you are away from it”. Don’t fight it just accept it and make sure your out of office reflects this.

Finally – do not install work emails via push on phones etc – keep it to desktops where you can devote sometime to doing it. Yes you can always “dial-in” via your phone but never feel you have to.

Sam Thenabadu, EM and PEM Consultant, Head of Stage 3, Deputy Dean GKT School Of Medicine

The Email inbox is on one hand a very public domain but on another a very personal place. Each of us has a style of inbox management that suits our personalities and paranoias, and though tombs of texts have been written (this included) on how to best control and command it, ultimately a sanguine, pragmatic and person centric approach is needed, even if your volume of emails is 10 a day to 150 a day.
Through my time I’ve had it on my phone, my ipad, my desktop and my watch. My new car is so smart now that the control panel evens tells me I have email. With such accessibility to being contacted below is my journey through ‘dealing with my emails’the words of an addict.

Sieve and sort I used to divide them into categories of clinically important and time critical, clinical but non time critical, non clinical but time critical, non clinical but non time critical, junk. I still try this but ultimately spent more time sieving than sorting.

Folders surely if I dragged them all to a separate to do folder I’d be more efficient?? Instead I just found they were out of sight and out of mind.

New to old or old to new Flip it! Most inboxes put the newest Email on top. This means if you simply start at the top the older ones get later and later to action. Flipping it kept me (slightly more) on top of the constant juggle.

Inbox Zero my obsessive years of trying to clear every email and have the sacred 0 (anyone else get palpitations when they see the number of emails on a friends email icon number bubble). I found I was half dealing with things simply to press the delete button.

Inbox Fear(o)– An adaptation of Inbox Zero that I scanned for the big hitters that would cause issues if I missed and delayed. The problem is these are often meaty so you don’t get a huge amount done.

Inbox ebb and flo(w) I get >100 emails a day for two jobs so now have to be realistic with myself that at some parts of the week I can’t keep up. At others can get lots sorted. I have email sign offs saying I respond at bizarre OOHs but I certainly don’t expect emails back till their working hours. I am strict with my OOO so that people are aware I’m not ignoring them but am away and cant generally reply.

Finally in ED not replying to an email rarely killed anyone. Be kind to yourself as it will still be there the next day and more than likely can be sorted or will already have been.

Further Suggested Reading
Mobile Phone Productivity
Getting things done
Email boundaries

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