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?

All of that should have been covered face to face by the surgeon, in clinic, when the operation was explained, the consent form was signed and he was added to the waiting list.

It’s not the job of some poor random administrator sending appointment letters out to explain what the operation involves (not least because for many operations it will be patient-specific).

But this thread is about paper letters - I'm not sure that would work in that circumstance.

I also think there comes a point at which people have to take a little responsibility for themselves. If the service keeps 6 phone number for anyone waiting for a transplant, you'd think that amongst those 6, there would be someone who hasn't changed their number in the last couple of weeks.

Our bookings for the local nhs hospitals can be done digitally for certain appointments but not all. You get a letter and it tells you to go to nhs.com/referrals and you put in your booking number and NHS password and can choose which local hospital you'd like and pick a time that suits you.
It's so convenient that I'm honestly surprised that not everyone has use of it.

I’m saying switching from letters to texts wouldn’t work for clinic appointments. Not that we should send letters through the post for transplant offers.

The six numbers were all out of service - some people apparently change their phone number on a pretty much monthly basis. And even when they have an incredibly good reason for keeping their hospital records updated, they don’t.

We do also have a similar issue with people moving house and switching GP and just assuming we’ll intuit this, but it’s definitely not as frequent.

I think it's disgusting. Such a waste of money, time, paper, postage. it takes so long. Surely the default should be app and / or email. Yes some don't have an email address, but many/ most do.

I phoned and got a lost letter re-sent. It took 10 days. A printed document with a link to sign up for a course. You click on it and it says an application form will be sent to you in the post.

It beggars belief. What a waste of time and money. And damaging me by delaying treatment. The nhs wasting money and delaying my treatment drives me mad. Disgusting.

So many issues....

Many people don't have or give an email address
Many IT systems (of which there are hundreds) don't have a place to even log an email address
Out new IT system this week doesn't have email functionality and doesn't have online booking. There's no money for this type of system - crazy I know.
Around 50% of our caseload don't have mobile numbers / need home visits / don't have a computer.
Many people aren't interested in giving their email address to you
Many people don't know they've been referred - all you get is a gp letter with a home address on and GPs aren't asking for email addresses
You'd have to phone patients to get an email address and when I've done that invariably it gets written down wrong. If I'm going to phone, I'd just book the appointment over the phone instead!

I'm could go on and on.
People are (understandably) clueless about how ridiculous the NHS computer systems are.

DH gets the digital comms but he also gets a copy of the letter sent to the GP, both by post.

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

It really doesn't. Computers do it all these days.

You also can't use an email address for clinical information (in my trust) we can only email other NHS addresses. So if the appointment letter says what the appointment is for, it can't be emailed (again, in my trust).

Not the computer systems in the NHS - that's the point. Mine has nothing on it related to email and it's fairly new. (But cheap and the only thing the trust could afford)

Although there will be some people in their 80s/90s who are digitally literate, the vast, vast majority are not, hence why I suggested starting digital-only for all 40-year-olds now, to wave through to everyone in coming years as people age.
I am 57 and I know some people my age and even younger who just 'don't like computers' as my generation bridged the gap between old and new technology (I started on a typewriter at work) and although the vast majority are like me, there are some outliers.
Basing your opinion of your experience of digitally-aware 90+ year olds is a bit unrealistic I think.
Anyone could opt in to digital-only, but my suggestion was to make it mandatory for those aged 40 and below.

@Katypp 100% agree more folk in their late 80s and 90s won't be comfortable with digital life as those that will, but I was really responding to all those - like you - lumping people over 40 as preferring post.
You have to remember most people in their 60s are still at work. Seriously, most people in their 50s and 60s are quite happy with e-mails and websites and texts.

But I do agree, the 'default' could be one way and the 'opt in / opt out' be an option.
It isn't just the cost of postage, but the cost of paper, envelopes, printing, and labour in terms of people putting the letters into the envelopes and posting them - it all adds up when you consider how many millions of us there are using the NHS. Then most letters I have had aren't just the appointment details, but they have information in other languages (that might not happen across the whole country? but certainly does in my City), and often a map of where to go (even when it is a repeat appointment) - which all makes the number of pages greater.

We generally only get post about once a week, too, which doesn't help matters.

I got another letter today confirming the appointment that I made on Wednesday 😕Surely this could have been done by text/email? I confirmed all my details when I made the appointment (on the phone). There are literally millions being spent on unnecessary postage by the NHS. Sorry but that seems to be the crux of it.

Oh I know that most people in their 50s/60s are digitally OK and most will have to be for their job.
My suggestion of 40 was to ensure that everyone who received mandatory digital communications were OK with it - these people will have been taught at school and will have entered the workplace in the early 2000s so there are no excuses!
Some of my generation still drag their heels for some inexplicable reason.

I am in my late 50s by the way, so I am not suggesting over-40s are past it!

It is not abour ages or being digitally literate, there are still many areas of the country without mobile signals or sufficient broadband speeds to access websites/apps/text messages. There is great pressure currently for the removal of landlines to the same areas in order to use VOIP which will not work. Therefore for those affected by these issues post is the only option.

Secondly, not everyone wants to give out a mobile number and/or email and their choice has to be respected.

An opt-in to digital comms is the only option. There also should be education, especially for GP services, that just repeating over and over again to rural patients, you need to use the app, login, access the website is not good enough. Too many people are slipping through the system due to the lack of understanding that digital connections are not 100% within the UK.

I am all for the NHS saving money, if only they could save money as quick as they seem to waste it there may be some improvements.

1. 99.7% of UK households have adequate broadband speed according to uSwitch so it’s a vanishingly rare problem.
2. You need to provide a phone number and/or email for the vast majority of utilities, mortgages, rentals and other basic services. Why is the NHS any different?

The paediatric audiology dept that my daughter goes to send emails instead of letters. Recently when I've had to have a mole removed my appointment was sent via the app and a text.

I don't believe this is a widespread issue. You can't decide policy on the problem that a minute proportion of people may encounter. Otherwise we would not send letters because a handful of people cannot read.
As for not wanting to give email address and phone numbers ... well that's just tough. You give your address, why not your phone number and email address, especially if it's in your own interest to do so.
We really do need to stop considering every little minute issue that a few people might have otherwise we will never make any progress in anything.

That still leaves 0.3% - you can give as many mobile numbers and email addresses to utility companies etc but if the messages do not arrive that is not helpful, the same with the NHS. It should not be an assumption that 100% are digital, just use an opt-in system for digital comms, then the 0.3% will not be forgotten.

What is the definition of adequate broadband speed? I can change to as many broadband providers as I wish, but my speed never goes above 0.2mb. What that means is it is difficult sometimes to download forms, access websites particularly if they contain lots of graphics/media. We have no mobile signal so texts and voicemails are only received when we go to an area with coverage. If the NHS sent and email, or text, or asked us to download an app and use it, none of it it possible. As I said in my previous post, take away the landline, or move it to VOIP (which will not work) and post is the only option for comms. Should we or those in the 0.3% be forgotten because U-Switch say 97% are fine?

Using an op-in decision for digital comms keeps everyone happy. It is very easy to say we should not bother with those who are in "not spots" if you have access to decent broadband and mobile signals.

Surely the NHS as a caring service should ensure everyone is able to be communicated by all methods, let the patients choose.

As to giving emails and mobile numbers, the reason we only give landline numbers and postal addresses, refusing to give emails/mobiles is if companies have them they tend to send emails and/or texts which we do not receive! Sometimes sense has to prevail!

Letters belong in the age of the dinosaurs.

The vast, vast majority of people have a phone, a mobile, or an email address.

I wonder how much it costs to send out all those letters - paper, printing, stamp? Boggles the mind.

I'm in the US and haven't seen a letter from a doctor since about 1999.

The lack of communication between different HCPs is a disgrace that probably costs lives.

EYE! singular not plural I clearly said "in his right eye" Read the post properly. And you STILL should explain to the patient what the aftermath will be. Informed consent should be a given not optional, opt out or a nice to have!!!! He was told it was a simple procedure.

YES and the current Emmerdale storyline with Belle and Tom featuring domestic abuse and reproductive coercion shows why face to face appointments are important especially for women.