The coronavirus outbreak has seen a sharp rise in guidance being emailed to primary care staff - and NHS Digital has told GPonline it is aware that some GPs are 'reaching the limit of their mailbox capacity'.
GPs have warned there is a 'very real possibility' they will miss out on key advice, because once the basic four-gigabyte size limit on NHSmail accounts is surpassed by a certain amount, users can no longer receive messages.
Doctors have called for a blanket increase in the size of NHSmail inboxes - warning that limited inbox space is creating 'constant stress' and forcing them to spend 'hours' deleting emails to free up room for incoming guidance. GPs have also reported being forced to come up with filing systems of their own - such as converting emails to pdfs for storage in separate Dropbox-type tools - to cope with the lack of space.
NHS Digital has not offered an across-the-board hike in the NHSmail inbox limit, but told GPonline that 'to resolve this challenge in a measured way that does not put unnecessary strain on the system, we have simplified the process of increasing mailbox capacity'.
GPs can now call a central helpline to request more space - and NHS Digital has promised that 'an incremental upgrade' will be carried out immediately for GPs who ask.
East London GP Dr Barry Sullman explained his concerns with the current inbox limit: 'If you are receiving attachments - and these days it is every day - these attachments use space and you rapidly run out of room in your inbox.
'The only way to keep going is to keep deleting - and this constant pruning may lead to inadvertently deleting a really important email. I have on a number of occasions deleted too much. You have to have an incredibly rigorous filing system of your own to empty the delivery point so that you can continue to receive emails.'
The Newham GP warned that there was a 'very real possibility' that people would miss out on guidance during the coronavirus pandemic simply because they lacked time to keep 'constantly deleting' to clear their inboxes.
Another GP said problems with NHSmail inbox capacity had become 'chronic' during the coronavirus outbreak, as the volume of emails with large attachments surged. He warned of 'information overload' as information arrived not only by email but also through local Whatsapp groups and other channels of communication.
Northumberland LMC medical secretary Jane Lothian told GPonline she was around 800 emails behind after just two days. 'There is an avalanche of information we are all separately trying to make sense of,' she said.
She also raised concerns about logging into the NHSmail portal - warning that she was often 'booted out' and struggled to log back in to access emails from different devices.
Chris Parsons, acting associate director of solutions assurance and programme head for NHSmail at NHS Digital said: 'We are aware that some GPs are reaching the limit of their mailbox capacity. To resolve this challenge in a measured way that does not put unnecessary strain on the system, we have simplified the process of increasing mailbox capacity.
'Rather than contacting local administrators to raise a purchase order for a higher limit, GPs can now contact the NHSmail support desk directly on 0333 200 1133 or firstname.lastname@example.org, requesting an incremental upgrade for their mailbox, which will be carried out straight away.
'We appreciate that GPs are under huge pressure at this time and are doing everything in our power to make sure that they are able to access the information that they are sent without having to worry about their inbox size.'