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?

It would be helpful if they put more detail in their letters. Someone i know has just had cataract surgery in his right eye and nowhere in the initial NHS letter or texts or phone calls did it say he couldnt drive for a week afterwards, They didnt tell him that till AFTER the procedure. So now he is stuck at home with very low gas and electric because he cant drive to corner shop to top up.
Why cant he walk??? Because he is still waiting for his knee replacement to be done by same NHS and his mobility is fucked due to the (so far) five year wait.
If they had let him know about the not driving BEFORE the procedure he would have topped up extra beforehand. Oh and hes retired so i guess they thought it didnt matter that he couldnt drive for a week despite his limited mobility

Informed consent anyone??!!

My rheumatology team are fully digital and it’s excellent.

neurology insist on sending paper letters a lot, but at least they have an email address I can contract when I am due an appointment.

I love digital because I can keep my records on hand- what exactly was DS’ last blood result etc, rather than carrying a big folder of paper around.

My employer requires hard copy and original letters if anyone needs time off for appointments. It's all paid for by employer, though.

Older people love the letters. As do people who need evidence to come to appointments.

As a pp said, these "older people" are becoming a smaller and smaller minority now. Everyone I know in their 70s uses e-mail and text and whatsapp.

I run a facebook group which has 4 people in it that I know are 90+.

Yes, there will be some who can't access text or e-mail but you could say the same about reading letters, which don't have google translate (or other apps for those who don't have much English), and which don't have 'text to speak' which many folk who need NHS services can benefit from, with technology.

You can't go spending £100miliion on postage, because - what, 10% ? - of people can't access technology.
As so many others have said - there should at least be a choice, or a way of opting (either in or out) to not receive letters.

The evidence to come to appointments, for the overwhelming majority of people, is on your phone

Where I live, when I need to make an appt, I get a text. I can almost always just go online and book an appt. If I don’t respond to the text in a timely fashion, then they start making phone calls.

if I need a prescription, depending on the level of refill I can either press a button for an automated refill or I can send a digital message to my doctor asking them to send a prescription to the pharmacy.

my lab results appear online too and the doctor can send me a message if she wants me to do something in response to the results.

visits and phone calls are saved for when needed. No phone tag. No wasted time.

people have the option of not switching to the digital system, but it works for the vast majority. That frees up the staff to spend their limited time actually speaking and working face to face with the people who need it.

the only hiccup was when my dd turned 13 and we had to switch her account over to a different status. Now once a year she has to authorize me to access her records and make appointments for her. That would be true whether we were digital or not, but it’s very annoying when you are used to making appointments on demand and discover you can’t book your child’s appointment until she signs some paperwork.

@NewName24

I wasn't saying I agree with it, it's just what I see through my work in a patient facing role. I'm probably the most digital person I know, I hate paper.

Agree. Email would be ok now. There could be a cc option for a relative too if wanted. The post isn’t that reliable so it isn’t foolproof. The eldest person I know is now 80 and she is a regular email user so we really are talking about what 10-20% of older patients who might want a letter instead?

Yes I agree. I had to have a gestational diabetes test, which my midwife told me was a blood test. I received a letter telling me about it and booked my appointment, first thing in the morning, thinking it would take 5 minutes then back to work. It was only when a friend told me it was a blood test, a drink, a 2 hour wait and another blood test that I realised I’d need the whole morning off! It didn’t say this in the letter. As you say, information A would be really helpful.

My employer used to ask us to take a form to be stamped as evidence we’d attended an appointment.
A letter only shows you’ve got an appointment, doesn’t mean you’ve been - as busybody admin person used to like telling us.
I don’t see why the NHS should be paying for the privilege of employers treating their staff like children.

My local hospital has Patient Knows Best. It's opt in so you can choose. I haven't had a paper letter for years so it can be done.

You would not believe the number of people with no phone, or multiple phones which change weekly, or who just don’t turn their phones in very often.

I have patients active on the kidney transplant waiting list who have missed out on transplants because none of the six numbers we have on the system for them or their family actually work.

And would writing to them have worked in this instance?

If you’re waiting on a kidney (which presumably happens at quite short notice) and make yourself uncontactable then I’m not sure what the NHS can do for you at that point, surely.

Hi OP, this is a great idea in theory but in practice is quite difficult. Different NHS Trusts use different systems that may not be wholly compatible with whichever patient portal the Trust is using without complicated integration work, as well as data protection policies to adhere to, support for when things go wrong digitally (eg: patient can't log in, patient wants to de-registered, patient wants to add a carer etc), signup and involvement from the different services, digital literacy etc.

...and to add - ensuring patient contact details are all up to date (cross checking that level of data is a mammoth task - no service would want to send information to the wrong person or where the patient may not want a text or digital letter (domestic abuse is an example) etc.

Obviously not in that instance no, but my point is that even when it is very clearly in their interest to be contactable by phone, many people aren’t. So moving to text reminders as OP suggests would result in more missed appointments.

We use letters, text notifications and PatientKnowsBest. And phonecalls from the admin team the day before for our frequent non-attenders.

Its ridiculous isnt it, My friend was told it was a simple procedure then handed a note and told afterwards, oh btw you cant drive for a week. A lot of people working in the NHS especially higher up have no idea of the way some people have to live.

And i have just had openreach text today wanting to do ANOTHER engineer visit insisting there is a fault on the line. It was fixed on Tuesday. The first engineer was here for ages, in the flat, at the green box outside and physically went to the telephone exchange in the town centre, If there are going to be constant faults and endless engineer visits and internet providers unwilling to pay engineers more so that they work weekends and bank holidays then we need to keep the letters

My parents and inlaws would cannot receive appointments any other way as they have no email and don't know how to read texts. They are 87-91.
I think it is unreasonable to expect elderly people to switch to digital appointments, but I don't see that as an excuse for not phasing it in to save money, if nothing else.
Maybe the plan could be that everyone from aged 40 downwards receives all their appointments digitally going forwards with no option for postal letters?
I am 57 by the way, and although I think it's pretty pathetic, I do know people around my age who 'don't like computers', so to me, 40 seems a reasonable age to draw a line at.

My 98 year old grandmother wouldn’t manage, but all my parent and ILs all nearly 80 are perfectly digitally savvy.

just make it opt in. Most people will choose electronic. some people, regardless of age will have barriers and need other forms of communication.

It’s not like letters and phone don’t have problems. People who move often and people who change their number for whatever reason are going to be difficult to contact through traditional methods. Those people are often just as vulnerable as the people who struggle with new methods.

Even better here - for some reason when they send me a letter they send it twice! I've spoken to a few people who have the same - and it continues despite telling them. Imagine how much that's wasting!

I get a bit fed of 'older people won't be able to do it'. How long do we say that for? My DPs are in their 80s and would be fine with an email/text.

They should only send a letter if people opt in to receive one maybe?

Someone i know has just had cataract surgery in his right eye and nowhere in the initial NHS letter or texts or phone calls did it say he couldnt drive for a week afterwards,

In fairness, I think common sense would dictate you can't have an operation on your eyes then jump behind the wheel of a car straight away.

I would have thought a letter arriving at a shared home, is much easier for an abusive partner to pick up and read, than a message on your own phone......