NHS now saying stuff is free.

[MixMaxChop]

Dear Mrs Chop

Welcome to NHS breast screening. We would like to invite you for your free mammograms. We have made you an appointment in a hospital that is not local to you in the arse end of a city that does not have any access from the railway station and parking is strictly limited and none of your previous mammograms have ever been in this city before but that’s not the point.

Free??

A) it isn’t free. My NHS contributions have paid for this many times over.

B) Surely “free” is the whole point of the NHS

C) are they craftily prepping us to have to start paying for services now in a stealth move to privatise the NHS?

Well it is a marketing ploy but that's because they are trying very hard to maximise uptake of all cancer screening.
While uptake of breast cancer screening overall has increased, among younger women it's well below target. That's women around 50 who have been called for the first time. As a former breast cancer patient I did some volunteering around cancer prevention, screening and treatment and saw how much effort is put into getting people to their mammogram.

Absolutely correct. I worked for nearly 50 years and my contributions wouldn’t touch the sides of how much I cost.

You can always change the time of the appointment. It's not a command.

I am now over the age when I get invited to an appointment. I will have to ring and make my own.

Not all NHS services are completely "free" at the point of use: I have to pay for prescriptions, pay towards my dental care and pay for certain features for my glasses. Some people may be frightened about additional charges associated with the mammogram. They are reassuring people that it won't cost them anything.

I can see your point but also why they’ve done this.

They want to encourage people to come and perhaps some would worry they’d be charged, esp if they’re not from here originally (perhaps these are the people not getting mammograms?)

But strictly it isn’t free. It’s included in the NHS provision that is available to all, paid for by public funds. But then we do always say “free at the point of care” rather than “included at the point of care” when lauding the NHS model so we can’t have it all ways!

I don't always see emails, a letter is better (lol) because then I write it straight on my calendar. (A paper one because I don't always look at my phone one.) In my trust there's an option to go paper free and they'll send a link to a website in a text.

I think a link with choices is the most user friendly way. No need to wait on the end of the phone then or for them to guess people’s availability/ make a random appointment that often won’t work for the patient.

free at point of access 🤦🏽‍♀️ there, I fixed it for you 🤷🏽‍♀️

I’m pretty sure 99.99% of people are intelligent enough to realise that all the barriers tge OP is describing are there.

Using the word FREE isn’t going to remove them or make people blind to them

The invite wording has probably been trailed to see what wording gets people coming in. Everybody loves a "freebie" so that probably has something to do with it.

All the private appointments I have had email has been used.

they attach a word doc which is password protected normally with either your date of birth or some such.

Except that
1- letters are often very late
2- nowadays theyre asking you to confirm you’re happy with the date and time. If you miss the confirmation window, that’s it. You’ve lost the appointment.
3- nothing is stopping you to write said appointment on your calendar straight away if you receive it be email. Or you could immediately put an alarm on your phone todo so if you’re checking emails out and about.

It’s probably been contracted out to a private company as part of the initiative to clear waiting lists. I’ve had a few letters like this with them emphasising that it’s ‘free’ or ‘There is no cost to you’ and it’s always appointments that have been contracted out. Some people might see the name of a private company or private hospital and refuse to go because they think they’ll have to pay.

@Gribouille

And I can see that 'free' is just to reassure people who've had to pay for eye and dental checks and might think this has a cost too.

Which is exactly the OP’s point.
Its a nice way to also make people used to the idea that not everything is (or is going to be) free.
You don’t need to remind people things are free when it’s considered normal. You wouldn’t have found that word in NHS communications 5~10 years ago.

Our trust is in the process of trying to do away with post for appointments. Last year it spent £850,000 sending out appopintment letters and that's only 1 hospital.

Problem is there is a lot of resistance from patients to changing to any technology based communication. There will be a percentage of patients who will have to continue to receive letters in the post.

Well they are hardly going to go into depth explaining about national insurance etc stop nitpicking.

It's part of the messaging that the NHS is "free" so think yourself lucky and don't complain about the poor treatment, admin foul ups etc!

I am amazed at what people can find to be annoyed about.
Not everything is a conspiracy. The NHS just want people to keep their appointments- or change them if necessary.

I hate this "you should be grateful" attitude. It's things like that that means awful experiences get normalised. "Be grateful: it's free".

Nothing wrong with stating the hopefully obvious fact that its a free service but the point maybe that if the appointment is 3 buses and a train away (we are not all car drivers), then is effectively isn't free and the distance can have financial ramifications too.

We have long waiting lists and whenever I see my GP, and need a hospital procedure, I get asked if I would be willing to travel so I could perhaps get an earlier appt elsewhere and I say yes. I think if this decision is being made for you with check-ups, that is wrong. Perhaps every patient should be asked by their GP for use going forward, if they would be willing to travel for preventative treatments i.e mammograms etc and the system directed by this response.

I do not drive and can't necessarily afford to take extended time off work for the appts, and yes I know employers should let you have time off for medical appts but its not always as easy as that and the pressure is for me to pay money to reduce the time I am away from work. And then there are the people who are physically, financially or emotionally not able to deal with extended travel for none emergency treatment.

I agree there is rooms for a few tweaks in the system to minimise inappropriate appointment allocation which would hopefully reduce those failing to turn up for appointments.

it isn’t free. My NHS contributions have paid for this many times over

Are you a really, really high earner because if you have had many mammograms, given birth in NHS hospital, had vaccinations, GP appointments you are highly unlikely to have made sufficient payments to pay once let alone multiple times over. Check out USA healthcare and see what bills you can expect if our NHS wasn't free.

Yes, there will be some who'll never adapt to apps etc. BUT, there are plenty who could (who use apps for other things), but have already found the myriad of different apps used by different trusts, even different departments in the same hospital, to be hard to navigate and express their preference of "paper" or phone calls rather than risk using the apps only to found there was no notification of a new message or that the message or appointment was put on a different app to the usual one that they don't know about etc.

Our GP surgery has different apps, one for repeat prescriptions and a different one for trying to get an appointment. They don't actually make that clear. They used to use the same app, but suddenly the ability to make appointments was turned off, so, patients would just assume you couldn't ask for appointments online anymore. It's only by ringing the surgery does the receptionist tell you about the "other" app. It's not mentioned on the surgery website, no links to apps etc.

It just doesn't make sense when DH's oncology appointments are sent by letter, even for his routine blood tests, but when the oncologist refers him for an x-ray, scan, or to a different dept, all within the same hospital, the appointments are a random mix of phone calls, texts or emails.

Make it make sense! Then perhaps more patients will be more amenable to the apps etc., well preferable a single app where you can actually see everything!

But I, in London, did get a letter sent by text and email inviting me to my appointment-using dare of north to open it.

the location wasn’t convenient compared to the hospital 15 mins walk away so I went online and waited until they released more appointments the following week and swapped to a better one.
all very easy to do.

It’s free at the point of delivery, the mammogram costs you nothing when you’re having it done.

Im glad I had my mammogram in December 2024, followed by surgery, 13 rounds of chemo, 10 radiation to be told it was gone in January 26.

ill take the free at the point of delivery any day.

I don't think anyone thinks you have to pay for mammograms, who are all these people that think they cost money on thte NHS?

No-one.

You are right OP, this is deliberate language.