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?

My GP surgery is nearly all digital. It’s brilliant and works so smoothly.

Last week I needed blood tests for anaemia. Messaged the GP via their website. GP responded that evening via email with a booking link for the local phlebotomy service at the local hospital. Managed to snag an appointment for the next day, but otherwise could choose a slot in 2 weeks. Instructions for attending the clinic were texted and emailed to me. All linked to my NHS app, where I’ll also be able to see the test results.

We have absolutely no issues with getting GP appointments same/next day (adults and children) because they can triage relatively minor issues remotely.

It won’t be too long before every generation alive is a digital native.

Our mail is unreliable so am very glad for mycharts option though still some insist on sending postal letters even though opted out. What is daft though is bloods taken at hospital GP can't see and one department at hospital offers me appointment another one doesn't know even for cancer tests, I have to tell them that a CT has been booked. And GP will redo bloods. Such an inefficient system and dangerous I would imagine to patients who can't remember themselves or vulnerable without others to help.

I think it varies in different areas. I get text reminders of GP appointments. My local hospital used to send texts for appointments and emails with letters as an attachment. This all works fine and those without a smart phone just have to remember GP appointments and have letters via post.

The hospital now uses an app so you get an email telling you to look at the app, though some appointments come via text. You have to input any health conditions and regular medication yourself. Personally I do not find the app very user friendly.

Weirdly, after my recent hospital visit, they printed my results for me to take home but did not send them to the GP - it should go electronically. I had to take my letter to the receptionist for her to photocopy and upload.

NHS IT systems are a mess.

There is no data sharing between different healthcare providers eg different hospitals , gp… as well as the appointment shambles.

I got a letter to say that my appointment in 6 months time was cancelled except that I never got that appointment in the first place so a waste of money informing me.

I am registered with the app and online appointments but get letters too. What a waste of money.

My local trust insists on sending letters but will at least also text appointment reminders, which often arrive before the letter. It can't even manage to talk to itself internally with any sort of efficiency, as DH discovered when he attended an oncology appointment the day after an investigative procedure IN THE SAME BUILDING and had to hand over his own paper results letter for the consultant to take away and scan because it hadn't reached him yet via the usual channels. The consultant started the appointment with "well unfortunately we've not got your results yet" so the plan had definitely not been for DH to take on courier duties.

I think the NHS probably wastes a lot of staff time with this sort of thing, but I also think it doesn't have the capacity right now to take a step back and reassess its processes. It needs a massive IT overhaul but we all know what happens to massive public sector IT projects.

Ours uses MyChart too and no longer sends out letters if they know you are registered on it. Having said that, I have received a letter, a phone call with the appointment date and had the letter put on MyChart for my last few appointments.

I agree that they can't abandon snailmail yet but you should be able to opt in to emails and texts or just getting messages on the NHS app.

That said, I wish I could opt out of emails for online shopping when I have an account/app with the shop and can get updates on that.

It's about fucking seven emails for one order. What a shower.

Fury after NHS spent more than £112m on POSTAGE last year – despite its goal to be paperless by 2020 | The Sun

Its The Sun so I can't vouch for the maths but seems to be around £100 million per year on postage 😮

Surely a quick fix is to use digital as the default and paper as the opt-in? I am aware not everyone has access to email but this must be a smaller proportion? Think what £100 million could buy the NHS each year (a new IT system?).

Also I agree with a PP re systems not linking up - and again I fail to see why it should be so difficult. Data protection shouldn't be a reason not to link up systems. Banks manage to do it.

P.S. I managed to get an appointment though 😊

UK Mobile Phone Statistics 2024 - Stats Report (uswitch.com)

80% of age 65+ in the UK own a smart phone

Just to clarify, as most people outside of the NHS don't realise, "The NHS" is actually lots of separate organisations who just offer services under the NHS banner. Sometimes they share premises, but it's like going to a shopping centre under one roof with different shops. Many of them use completely different technology, depending on what suits their processes and services best. So unfortunately, to get "The NHS" to digitise and email rather than post would be an even bigger undertaking than you'd think.

Thanks @proudpeonies I'm genuinely interested so I appreciate the explanation.

Bits of the NHS do have digital booking, although they did send me a letter to tell me how to login and book my appointment.

but generally, digital services in the NHS are a shitshow. Lots of different organisations involved, lots of different IT systems that don't talk to each other, a load of issues with different bits being unable or not allowed to share patient data. An IT division tearing their hair out because they get a new system developed and then some government numpty will tell them to scrap it and do something different.

Pre-Covid, I used to book ds2's next clinic appointment with the receptionist, at the end of the previous appointment. He goes every 3 months. Then they stopped letting you talk to the office staff. So we get an appointment letter in the post, and then I phone to change it to a time we can do, and they send me another letter to confirm. The week before the appointment I get a reminder letter. I also get a (non-automated) reminder text from ds2's clinic nurse. I get occasional emails about social/educational events arranged for kids with his condition too. It's just the appointments that require 3 letters in the post.

Cause it's incapable of change.

I was waiting to see my orthopaedic specialist.
Got a mail on my NHS app " Paitents know best.
Have you registered.
Gave me an appointment.
Get all mine like this.
I can see letters my GP sent to the hospital etc.
Asking for appointment and what they wrote.
With an opportunity to change appointment if not convenient.
Mid Yorkshire NHS Trust.

I get letters, emails, texts and information on the nhs/My Pathway app.

The letters normally come after the emails/messages.

There doesn't appear to be an option to opt out of the postal communication.

Because the internet isnt reliable enough. We have had three engineer visits inside of a year.

This is going to become less and less I'd have thought though.
My parents and in laws are in their 70s and all use email, texts and apps competently.

Most of the older people I know use smartphones, Tablets or computers. My grandparents didn't but they were in their 90s (died in recent years) though my grandad was trying to get to grips with it.

In a few years time the number unable to use technology, etc is going to reduce massively I'm sure.

So starting an opt out system now would be good, so it can gradually be used less and less. Postage costs must add up. And you'd probably end up with less missed appointments - so many times letters arrive after the appointment has happened!

Do you leave messages and offer a way for them to contact you easily?

I'm curious as my rheumatology department only calls once and, although they leave a message, you can't call back directly. You have to go via the switchboard and answer message system. They then will call you again - normally within 48-72 hours.

But I can't answer my phone in school hours so the cycle continues over and over until I happen to fall lucky that they call me during a break time.

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

My hospital letters come via email and/or app. They are password protected - the PIN code is sent separately to my mobile number,
So the nhs don't seem closed to the idea of digital letters - I just get both postal and digital, same letter but in different formats. 🤷

I had a text message from them asking me why I hadn’t turned up for an appointment sent by letter, didn’t get the letter till after the event.
The costs in terms of stamps, paper, envelopes and time it takes someone to print it off etc. compared to a computer generated text, once an appointment has been scheduled must be significant.

If only there could be an opt-in to email correspondence. Surely this would cover 95% of the population by now? My dm was using emails for at least 10 years before she died at 92. She never had a smartphone or online banking, but emails have been around for 30+ years.

Because the postal service is now so utterly shit where I live (London fgs!) there are countless people who have missed hospital appointments. Just imagine what that's cost the NHS?

Agree

Dh was waiting for an appointment

I chased it up today to be told it next week and letter was sent last week

Which we didn't get. Maybe due to bank hol post or maybe lost

If hasn't of rang we wouldn't have known ans wouid have missed it

Sending via email wouis have been easier and quicker and cheaper

Think how much money nhs can save on paper ink Envelopes and postage

The real problem is not that they are different shops in the mall - its that they are different shops who actually refuse to cooperate in any way whatsoever.

Successive governments have spent billions trying to implement systems around data and communications for all trusts to be able to use. Every effort falls foul of one or more of the fiefdoms refusing to cooperate because they want to dictate the solution for the whole country or simply won't share a solution preferring to have their own based on a recommendation from the IT director's Uncle Fred.

Systems which could and should have been centralised for cost X end up being implemented slightly differently 20 times in different regions at cost 10X because every fiefdom wants the whole solution built to its preferences or doesn't want to share. This of course also blocks data sharing, the primary use case for patient benefit. Some are simply never implemented.

We are decades behind other developed countries, not because the money has never been put into these areas but because the billions spent are wasted too often due to non accountable fiefdom leadership antics whilst their actual medical staff lack basic equipment and numbers.

Excatly and or does not have the capacity to thoroughly check all important emails in a timely manner. Many people forget and want a hard copy. Some want to keep a record

We've had the internet since around late summer of 96. At that time, no one we knew at work, friends, friends of friends etc had internet. (Our children were seriously into computers from a young age , hence the net) but I'm only good at stuff I know and cant master my emails like our kids .Re mobile phones, we had them early but only recently started using apps on the, 3/4 years with a lot of help and persuasion from kids

Therefore, just because you feel ok with electronic communications not everyone has the capacity or feels as sure as you do