Even Practices which rely entirely on the paper copies of their letters inward and outward and have no intention of becoming paper-free need some provision for relating correspondence to whatever computer records of encounters and summaries they maintain.

The NHS has essentially standardised on Microsoft Office products, most letters from hospitals will be produced in MS Word and many letters to hospitals will be produced by a combination of a specific function of the clinical system, usually producing a plain text file, and Word for the finishing touches. Even e-mailed letters seem likely to come as Word attachments despite the large bandwidth needed.

Letters in and out of the Practice should be viewable from within or alongside the patients' records.

GP computer systems therefore should be able to deal with Word documents.

Considering the GP Clinical system as a word processor, we see it usually falls far short of what we could reasonably ask for.

Most systems also fail to provide means of exporting an entry - thus the increasingly common entry in a hospital letter "This is a copy of the notation in the patient's notes" (and which admittedly usually means in the hospital that the secretary has read the handwritten note and copy typed it - or typed two copies from a dictated tape) cannot be accomplished in General Practice with a referral letter giving a copy of the notation in the patient record, nor can the letter be easily embedded in the patient record.

Exceptions to this limit the user to a text processor with none of the facilities expected by secretaries including spell-checking.