Why does the NHS send letters?

[Magnoliasunrise]

Genuine question and I am not having a go but why does the NHS post letters?

I am waiting for a physio appointment and received a letter on Friday dated 1st May. I have 7 days from date of letter to ring and make an appointment. The booking line was closed Saturday and Sunday obviously. It was a bank holiday on Monday and yesterday when I phoned on my lunch I realised the line closes for half an hour at lunch. Hopefully I can get through today if I change my lunchtime but it is the last day I am able to book.

I checked my NHS app and the letter isn't registered on there and has no way of digitally booking. I think this could be a super easy way of saving the NHS a MASSIVE amount of time and money - move to digital appointments. Maybe each trust is different or maybe I am missing something? Genuinely curious if anyone knows why not?

I think you should be able to opt in to digital communication

there’s always going to be a small percentage of people who letter would be the best option . But I think the majority of people would welcome the change to online info

Ah come on op surely you must realise not everyone has an email address? Mobile phone? Some might not even have a landline. And even if they do have all of these some are unable to use them for loads of reasons

I agree the letter situation is not fit for purpose though as sometimes the letter turns up after the appointment

I'm guessing that there are hundreds of thousands of people who wouldn't be able to access documents on the app, nor would they be able to access email

Text is an option, perhaps, as a reminder, but not everyone uses text

Perhaps the NHS could ask each patient if they'd opt out of postal communications, but that takes a level of organisation and finance which its possible the NHS doesn't have right now

We get a text and a letter. And if it's an appointment we are booking at ten smae time as we are already there, a print out at the desk!

I agree with you, I'd love to opt out of the letters.

I agree OP. They need to set up some kind of opt in/opt out thing. My whole pregnancy, I would book my next appointment with my midwife, I’d then get it sent digitally on the NHS app and then a week later I’d also get a paper copy in the post. Complete waste of money and paper.

not everyone has a mobile phone or email address, but at the very least the vast majority of people of childbearing age do, so perhaps maternity would be a good place to start.

not everyone has an address either but we don’t use that as an excuse for not sending letters!

Older people struggle with online though. My in laws struggle with email and signing up digitally for anything. Despite numerous offers of help and us showing them.
People who are less dexterous , have poor vision, low income so no smart phone, poor memory so need that visual reminder of a letter...
There's lots of reasons why the NHS can't abandon paper, although opting in to digital communication is one way of reducing it.

I completely agree, I lost my dad to cancer last year and my partner has recently had tests although luckily they appear to be clear - well we’ve been told that but the letter has never arrived - apparently it’s been sent but seeing as 2 from January only recently turned up I’m not convinced.

With my dad it got so confusing, he’d often get the letter after he’d already had a text reminder or phoned to chase an appointment - the combination of a failing NHS and a terrible post service doesn’t make for an efficient system.

We were also told they use letters due to data protection but I don’t see why results can’t be uploaded to your NHS account or something, we do it with all sorts of other things that need security.

I’m tired of hearing how people can’t/wont use technology, of course there will be exceptions so I agree an opt-in system would work best but we can’t just make excuses - the world is moving to digital and it’s our responsibility to keep up with that.

In our team it's because when we try and phone patients they never answer! We try twice then write asking them to call us. Although we mostly work with older frail people who might not be able to get to the phone so it is understandable, they also often forget a call so a letter they or family have jn their hand makes it more likely they attend.

I agree - it should be ‘Opt in’ to letters! There must be so many appointments missed and time wasted because of it.

I've had a few letters arrive after the appointment date too, contributing to 'missed appointments.' if they'd sent an email I would have been there.
I get that not everyone uses email but huge swathes of the population do, they could opt in!
The postage and printing bill must be huge.

Definitely should be an opt in to digital communication process.

i was given printed discharge summaries last time i left hospital and then received the exact same paperwork in the post a week later. I mean what was the point in that? Someone was paid admin time plus the cost of the postage for that nonsense.

Meanwhile 3 weeks on I still haven’t got notification of the two follow up clinics I was allegedly referred to for 6 weeks after discharge.

I agree OP our mail delivery service js awful - new posties all the time who deliver stuff to the wrong address. I recently didn't receive my breast screening results so had to call them. A waste of everyone's time. The results should be automatically updated on your NHS record and a text or email sent.

The even bigger issue is the regularity with which snail mail arrives too late to to change an appointment if you can't make it or even arrives after the appointment has been and gone. Other groups/trusts manage to use email and text messages. The idea of charging patients for missed appointments is laughable when so many of the sub groups fail on the basics of record keeping and comms.

Having a consistent and effective system of communicating with patients rather than lurking in the 1980s would require a patient first approach and for different groups to cooperate on common approaches. The latter is basically impossible to achieve in the NHS.

Mind blowing how much they must spend on this. Where I am, you get a text then a follow up text the week before where you have to confirm or cancel your appointment then an automated call the day before. Works well .

I think most trusts are digital by default now, or should be. It's been a requirement for quite some time to move towards digitization. Some trusts are just better than others, as with all things.

@Primefungus - same here!
I work in the NHS and I usually arrange appointments with patients/families over the phone. If I can't catch them on the phone, I'll arrange an appointment for 2-3 weeks' time and send a letter to them instead. Gives them time to receive the letter and then call us to rearrange if needed.
We don't have an online booking system where I work.

I don’t know what the solution is. But all that admin time, postage and paper must cost a fortune. Especially when you get more than one copy of the same letter! Or it arrives too late for the appointment anyway!

Maybe an opt in for digital? And gradually it will move across the population. I don’t know if that’s possible or practical though.

Being able to select an appointment time, rather than being allocated one seems sensible to me too. But I suppose that has its logistical challenges too

It is due to a number of factors including the fact that the NHS can rely on patients being at the address registered by their GP who is the referrer.
There are many digital systems that don’t synch up and many GPs can’t cope with emails. Once a patient is in a particular service there are often ways of receiving text messages and occasionally emails.
If appointments are missed due to a letter not being sent out then the patients lose out and it’s not equitable health care as many don’t have internet access or mobile phones. Also in these stricken times the hospital loses the payment from the GP/ referrer/ clinical commissioner; with a letter sent they cover all bases.

I ended up with PTSD as a letter arrived half an hour before an appointment at which I found out I had cancer. I was on my own and practically naked as I didn’t have time to read the letter and dress appropriately. I needed months of therapy - it must have cost the NHS a fortune. I would have preferred an email or a message on the app.

There is already an opt in for digital communications. I think there is still a concern about the digital system not being 100% reliable/people not being diligent about checking the NHS app. (I found a cancelled appointment on my record by chance while looking for something else. Usually I get a text, but not this time, so I will have to get on and rebook that one).
I opted in to the digital system a year ago, but I still get the occasional letter.
There are lots of people who either cannot or will not use a digital system. I have got a couple of elderly friends who are absolutely paranoid about any sort of technology. One won't even have a mobile phone, neither of them will even attempt to use online banking, for example.
The NHS systems are really not good enough to roll out a reliable service, whether it is paper or electronic.

Because their main concern is patient confidentiality. Sending letters is still seen as the most secure method of sending confidential information.

Faxes are dead. SMS is not suitable. Email is completely unsecure - it is not encrypted. Also people change Email addresses regularly and would forget to update the NHS.

There is now the option to be notified via their confidential messaging system which is secure but that is a relatively recent thing.

Our hospital has mycharts through which they send letters, results etc which you have to register for and opt out of postal letters. It's far better than letters for me, also cancer patient.

I have had similar issues in the past, and it was a real issue when MIL was still with us. She had a lot of health issues and lots of appointments with different departments; all came by letter - to be fair she could not have dealt with electronic communication- but they regularly arrived the day of, or day before the appointment, at which point it was a scramble for DH or I to organise time off (again) to take her

Appointments would overlap. Sometimes scheduled for during a hospital stay but sent to her home - surely they can see she’s been admitted?

Oh dear, I am on a rant. In short, locally it’s shambolic.

I was thinking this very same thing this morning.

Yesterday I phoned up a hospital department to check they'd received a referral for my daughter and to ask how long the waiting times were currently. I explained I'd been waiting a month so wasn't sure if the referral had been received, and I enquired if I'd get confirmation of her being on the waiting list. The lady I spoke to was aghast at this suggestion and said there is simply no way that they could possibly have the time to let everyone know once their referral had been received.

Why they can't use an automated service like so many other services I don't know. I work in projects so know full well how slowly things change within public services, but surely it's about time it was at least in the pipeline of inprovements to be made. An email or text at each stage of the process, and a text for appointments.

Some GP surgeries have been able to move over to online booking and text reminders. I find it strange that it's not a system wide approach.

And the fact they still insist on sending everything by snail mail and not email is quite bizarre. As others have said, it should be optional how you wish to be contacted.

There are a lot of older people who are not tech savvy and don't have either email or smart phones, my mum included.

I've now set up my mobile number on her doctor's record so that texts including those with links to letters come through to me to sort out. You can reply to the text with the word PRINT if you're picking it up on a non smart phone.

I find the lack of consistency annoying as she'll still get letters from some hospital departments, texts and phone calls from others. She even once had a hand delivered appointment letter.