The learning resource suggests a number of approaches around this factor. Firstly, simple, common sense, flexible approach into existing practice as the most effective way to minimise workload implications for clinicians. Appropriate ongoing communication and information also emerged as a way to emphasise that the change and resources required for implementation are modest if a flexible approach was taken towards implementation. Finally, information and communication to patients is emphasised particularly in terms of encouraging patients to let clinicians know upfront if they wanted a copy letter to save time and resources in the long term.