Form Reality Check: Submit Two Real Scenarios and Time the Experience

Online forms are now a core part of “modern general practice” in England, with practices required to keep online consultation tools open throughout core hours. This makes it essential that your forms are not just live, but safe, clear, and genuinely usable for patients and staff.

A “form reality check” is a structured way to test your own forms using real scenarios, so you can spot problems before patients do.

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What is a “Form Reality Check”?

A form reality check is a simple, practical test of key journeys on your website using real-life scenarios.

Pick two real scenarios, for example:

• New patient registration
• Medical history update with file upload (e.g. clinic letter, red book photo)
• Referral request (e.g. physio, mental health, community service)
• Travel clinic or vaccination request

Then run through each scenario from end to end, timing the experience and checking:

• How long it takes to complete
• Whether errors are clear and helpful
• Whether the confirmation message reassures the patient
• Whether the submission lands in the right inbox and is understood by staff

Pass criteria

• Both test submissions can be completed smoothly in a reasonable time (e.g. 5–10 minutes for registration; 3–5 minutes for a simple request)
• Error messages are clear, human and non-threatening
• Confirmation messages explain what will happen next and when
• The correct staff inbox receives the request, and staff can clearly see what they need to do

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How to Run a Form Reality Check in Your Practice

Step 1: Choose two realistic scenarios

Aim for common and important journeys.

• New patient registration (NHS requirement and high-volume)
• Travel clinic or vaccination request
• Referral query (e.g. chasing hospital referral)
• Medical history update with file upload (e.g. condition summary, discharge letter)

Key tip

• Use real, anonymised or dummy data that mimics what patients actually type, including free-text, punctuation and typical mistakes.

Step 2: Time the full journey

Start a timer from the moment you land on the form page to the final confirmation.

• Record how long it takes a non-clinical staff member to complete it without prior explanation
• Repeat with someone who is not a digital native (e.g. a PPG member, practice admin who doesn’t manage the website)

Red flags

• New patient registration regularly taking 15+ minutes
• Travel clinic or referral requests taking more than 5–7 minutes for a simple case
• Long, dense pages with no progress indicator

Step 3: Capture where users struggle

Make notes as you go.

• Fields that are confusing or use jargon (e.g. “ODS code”, “NHS geographical commissioning region”)
• Places where you’re unsure what to select (e.g. “admin”, “non-urgent clinical”, “other”)
• Upload steps where you’re unsure what’s acceptable

Then check these against NHS England guidance on “highly usable and accessible GP websites” and the NHS online forms guidance (for example, making clear how to request urgent help and what the form should be used for).

Step 4: Check the end-to-end workflow

After submitting:

• Confirm which mailbox receives the submission
• Check whether the subject line and content give enough info to route it correctly
• Ask the relevant staff member:
  • Could you tell what this was about without opening attachments?
  • Was any critical information missing?
  • Did it land in the correct inbox automatically?

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What to Write in “For / Not For” Boxes

Clear scope messages (“this form is for…” / “this form is not for…”) are now essential for safety, patient expectations and NHS online consultation requirements.

Why “for / not for” text matters

Done well, it:

• Keeps urgent or unsafe requests out of the wrong channel

• Reduces admin chasing (“this isn’t the right form for that”)

• Improves compliance with NHS requirements to clearly signpost how to seek urgent help

• Helps meet WCAG clarity and readability goals by using plain, predictable language Good practice principles

• Use plain English and short sentences

• Put urgent care instructions before the form questions

• Keep reading level to around age 11–12

• Avoid jargon such as “online consultation,” “admin workflow,” “triage model” in patient-facing text

Example: New patient registration form This form is for

• People who want to register as a new patient with our GP surgery

• Patients who live within our practice area (you can check using our postcode tool)

• People who want to move from another GP in England to our practice This form is not for

• Urgent medical problems – phone the surgery, NHS 111, or 999 in an emergency

• Changing your address or contact details (use our “update your details” form instead)

• Temporary visitors to the area (please phone us for advice)

• Private medicals, insurance forms or reports

Example: Travel clinic form This form is for

• Asking about travel vaccinations or malaria tablets
• Travel that is at least 8 weeks away

This form is not for

• Urgent medical problems before or after travel
• Travel within the next 2 weeks – please phone the surgery
• General vaccinations such as flu or childhood immunisations

Include a short, clearly visible note:

• “If you are not sure this is the right form, call the surgery for advice.”

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Error Messages That Don’t Scare Patients

Many form systems use default technical or alarming errors. In healthcare, this can increase anxiety and discourage digital use.

Principles for patient-friendly error messages

Tone

• Calm, neutral, solution-focused

• Avoid blame or “telling off” Language

• Say what went wrong in plain English

• Tell patients exactly how to fix it

• Avoid technical terms like “validation error”, “invalid token”, “server error”

Accessibility

• Errors must be programmatically associated with fields (for screen readers)
• Use colour plus text – don’t rely on red alone
• Place error messages close to the field and provide a summary at the top where possible Better and worse examples

Good examples

• “Please enter your date of birth in this format: DD/MM/YYYY.”

• “We need a UK mobile number so we can contact you about your care. Please check and try again.”

• “This field is required so we can process your request.” Poor examples

• “Invalid input. Try again.”

• “You have not conformed to the expected field format.”

• “Error 500 – internal server error” (show a friendlier message and handle the tech behind the scenes)

For sensitive questions (e.g. safeguarding, mental health)

• Avoid frightening language if an answer is missing:
  • Instead of: “You must answer this safeguarding question.”
  • Use: “This question helps us keep you safe. Please answer if you can, or call the surgery if you’d like to talk instead.”

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File Upload Guardrails

Patients increasingly need to upload documents (hospital letters, adoption papers, red book photos, medication lists). Without clear guardrails, uploads can become a clinical risk or a data protection problem.

What to allow – and what to avoid

File types

• Allow common formats:
  • PDF, JPG/JPEG, PNG, DOC/DOCX (if practice systems can safely handle them)
  • Avoid:
    • Executable files (.exe), macro-enabled documents, archive files (.zip) and other risky formats

File size

• Set a sensible upper limit (for example, 5–10 MB per file), clearly stated next to the field

• Tell patients how to reduce size (e.g. taking a photo in good light without zooming in too far) Number of files

• Limit to what staff can reasonably review (e.g. up to 3–5 files)

• Ask patients to select the most important or most recent document Clear instructions next to the upload field

What to upload

• A clear photo or scan of:

  • Hospital letters related to this request
  • Clinic summaries or care plans
  • Red book or vaccination records (for children)
  • Medication lists What not to upload

• Photos of intimate areas – explain these should be discussed with a clinician first

• Photos of urgent or serious symptoms that need same-day assessment – direct to phone/999/111

Example wording

• “You can upload up to 3 files (PDF, photo or Word document), each up to 5MB.”
• “Please only attach documents that are relevant to this request.”
• “Do not upload intimate photos. If you are worried about a private area, please call us to arrange an appointment instead.” Safety and IG considerations
• Confirm that uploaded files flow into a secure clinical system or secure practice mailbox
• Ensure there is a clear workflow so staff know:
  • Who checks attachments
  • When they are checked
  • How they are stored or added to the record
  • Make sure your privacy notice explains how uploaded information is used and retained, in line with UK GDPR and NHS data protection expectations.

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Route to the Right Inbox Every Time

Routing is where many otherwise good forms fail. Poor routing increases clinical risk, delays care, and frustrates staff.

Map your form types to inboxes

Start by listing all your online forms and how they are currently routed.

Example mapping New patient registration

• Routed to: Registration/records team inbox
• Escalation: Queries flagged to practice manager or nominated admin lead

Medical history with file upload

• Routed to: Clinical workflow inbox (e.g. “Docman”/“clinical workflow”)

• Escalation: Duty doctor or named GP if urgent wording is detected Referral or referral query

• Routed to: Referrals/secretaries inbox

• Escalation: Named GP or duty doctor where clinical decision is needed

Travel clinic form

• Routed to: Practice nurse or travel clinic inbox
• Escalation: Prescribing clinician for anti-malarials or complex cases

Use smart questions to drive routing

Many systems allow simple rules based on the patient’s answers.

• If patient chooses “I’m registering a child” → send to paediatric registrations queue or highlight in subject line

• If patient selects “This is about a referral” → send to “Referrals” inbox

• If patient chooses a red-flag answer (“I need help today”) → route differently or tell them to phone Practical tips

• Standardise subject line prefixes such as:

  • “[ONLINE] New patient registration – adult”
  • “[ONLINE] Travel clinic request – 10 weeks+”
  • Always include:
    • Patient full name
    • DOB
    • NHS number if available
    • Priority indicator if used (e.g. “Routine admin”, “Clinical – review within 2 working days”)

Test routing in your reality check

For each scenario:

• Submit a real test form
• Confirm:
  • Which inbox received it
  • Whether the subject line made sense
  • Whether staff could triage it without extra clarification
  • Ask the receiving team:
    • “If this was real, would you know what to do, and by when?”

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When to Bin the Form Plugin and Rebuild

Sometimes incremental tweaks are not enough. If your form system is causing safety risks, accessibility failures, or severe workflow problems, it may be time to replace it.

Warning signs your current solution is no longer fit for purpose

Consistent patient complaints

• “The form is too long/complicated.”
• “I never know if the form has gone through.”
• “I don’t know which form to use.”

Accessibility failures

• Labels are missing or unclear for screen readers

• Colour contrast is poor (light grey text, pale buttons)

• Error messages are only shown in colour without text

• Form doesn’t work properly on mobile Operational risk

• Submissions regularly go to the wrong inbox

• No clear way to separate clinical and admin requests

• No audit trail for who handled what and when

• File uploads are unreliable or unsafe

Technical or compliance gaps

• You cannot configure:
  • “For / not for” messaging
  • Accessible error messages
  • File size/type restrictions
  • The supplier:
    • Cannot demonstrate compliance with UK data protection standards
    • Provides no accessible design assurance (e.g. WCAG support)
    • The system cannot meet NHS England requirements to keep online consultation tools open and safe during core hours

If you decide to rebuild

Define what “good” must include

• Clear, configurable scope messages for each form

• Strong, customisable error handling

• Accessible design (keyboard navigable, screen reader friendly, WCAG-compliant)

• Flexible routing and workflows aligned with your practice model

• Safe, controlled file upload with clear patient instructions

• Strong audit trail and reporting Involve the right people

• GPs and nurses (clinical safety)

• Practice manager (operations and contract compliance)

• Front-desk/admin staff (day-to-day reality)

• A small group of patients/PPG members (usability and accessibility)

Build with reality checks baked in

• Schedule regular form reality checks (e.g. quarterly)
• Each time, re-test:
  • New patient registration
  • One clinical/admin request type
  • A file upload journey

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Key Takeaways

For / Not For text

• Every form should clearly explain what it is and is not for.

• Use short, plain-English statements and always signpost urgent care routes. Error messages

• Keep them calm, clear and instructive.

• Avoid technical jargon and frightening language, especially around safeguarding and mental health.

File uploads

• Allow only necessary, safe formats, with clear limits.

• Tell patients exactly what is and isn’t appropriate to upload, and why. Routing

• Map each form type to the correct inbox and team.

• Use smart routing rules and consistent subject lines so staff know what they’re opening.

Rebuilding

• If your tools can’t meet safety, accessibility and workflow needs, replacing them can be safer and cheaper in the long run.
• Involve clinicians, admin staff and patients, and commit to ongoing “reality checks”.

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Next Steps for Your Practice

Run your first reality check this month

• Pick two journeys:
  • New patient registration
  • One other: travel clinic, referral, or medical history with upload
  • Time them, collect notes, and review with the relevant teams.

Quick-win improvements

• Add or improve “for / not for” boxes on all forms.
• Rewrite your error messages into plain English.
• Tighten file upload settings and on-screen explanations.
• Review routing rules and confirm each form reaches the correct inbox.

Plan for continuous improvement

• Schedule quarterly reality checks with rotating scenarios.
• Monitor patient feedback and complaints about online forms and act on recurring themes.
• Keep an eye on evolving NHS digital and accessibility guidance and check that your forms stay compliant.

By regularly submitting your own forms, timing the experience, and following the patient journey into your inboxes, you turn your website from a simple “front door” into a safe, efficient digital service that genuinely supports modern general practice.