Royal Mail’s cuts pose risk to patient safety, warn NHS chiefs
Royal Mail’s plans to cut second-class deliveries risk patients’ safety, NHS chiefs have warned, as new figures suggest late letters are to blame for a quarter of missed hospital appointments.
Deliveries of post with second-class stamps are going to be reduced to every other day under proposals announced on Wednesday to save the loss-making postal service money.
However, in a letter to The Telegraph, NHS leaders and leading patient groups warn that the “worrying plan” could put people who are already facing treatment backlogs at risk of harm.
They also reveal that more than two million of the eight million missed hospital appointments last year are thought to be the result of patients receiving a letter informing them of their appointment after it was supposed to have taken place.
In their letter to The Telegraph, the chief executives of NHS Providers, Healthwatch England, the Patients’ Association and National Voices said: “We have raised direct concerns with Royal Mail that this worrying plan may worsen patient safety risks.
“Provisional Healthwatch data suggests that more than two million people may have missed medical appointments in 2022-23 due to late delivery of letters, and this will only deteriorate under the proposed new plans. We have made it clear that if the plans go ahead, a solution must be found to prioritise the huge numbers of letters sent from NHS teams, otherwise more people will miss time-critical appointments, appointment changes or vital test results,” they wrote.
Many types of NHS letters, such as time-sensitive appointment bookings, test results, and treatment plans, currently use second-class stamps.
The NHS is already contending with an official backlog of 7.6 million, while data from the Office of National Statistics released this week found that the true number of people waiting for an appointment, test or procedure may be as high as 9.7 million.
Last week the annual British Social Attitudes survey found that public satisfaction with the NHS had dropped to its lowest level on record, with fewer than one in four happy with the service. The public’s unhappiness was driven by GP and dental practices, but reflected across all services.
New data published on Friday revealed that one in four ambulances were waiting outside A&Es for longer than half an hour to hand over emergency patients, preventing paramedics from attending new cases, when the target is 15 minutes.
The health service has also experienced repeated strikes by doctors over the last year. On Friday, consultants announced they would end strike action after accepting a new pay deal worth up to £20,000 a year.
Sir Julian Hartley, chief executive of NHS Providers which represents hospital trusts, ambulance services, primary care networks, told The Telegraph the proposals to delay letter deliveries were “extremely unhelpful”.
“It’s really important that patients be updated at the earliest opportunity on developments in their care and treatment,” he said.
“An efficient, punctual postal service remains a key part of that process. At a time when far too many patients already face long delays – the last thing any trust leader wants – anything that adds to that uncertainty, and possibly the worsening of conditions, would be extremely unhelpful.”
Healthwatch England, a think tank that makes recommendations on how to improve patient care and safety, said around 3 per cent of the 82 million hospital appointments confirmed with a letter involved letters arriving after the appointment date, based on a representative sample of 2,100 people.
It found that two thirds of the public still rely on letters from the NHS to know when their appointment is and other medical information.
Experts estimate that the cost of Did Not Attends is around £1 billion a year in lost NHS productivity.
Exasperation at late deliveries
Louise Ansari, chief executive at Healthwatch England, said it had “heard worrying stories from people who are exasperated by the late arrival of crucial NHS post”.
“When appointment letters, test results and other communications from the NHS are delayed, patient safety is put at risk, while NHS teams must deal with the fall out of missed appointments,” she told The Telegraph.
“We are concerned that the proposals to further delay posting of letters will make such risks more widespread.”
She added that it would increase health inequalities among those who rely on post and have less access to digital technologies, and urged the Royal Mail “to ensure the most pressing NHS correspondence is not delayed further for the most vulnerable patients.”
Royal Mail is campaigning for a shake-up of postal regulations as it grapples with a slump in letter sending that has pushed its finances to the brink.
The company lost £319 million in the first half of the year as it warned letter volumes were likely to drop to 4 billion in the next five years, down from their peak of 20 billion two decades ago.
The troubles have been compounded by strikes that cost the company £1 million per day as it clashed with unions over pay and conditions.
Meanwhile, Royal Mail has repeatedly failed to hit quality of service targets that require it to deliver 93 per cent of first-class mail within one working day and 98.5 per cent of second-class mail within three working days. It had achieved 73.7 per cent and 90.7 per cent respectively.
The Royal Mail also faced a backlash earlier this year when in separate plans it suggested delaying bulk mail deliveries including from the NHS from two to three days.
Concerns about proposed delays to deliveries of medical letters were echoed by patient groups who said the disruption would leave “patients uninformed about important developments in their care”.
Rachel Power, chief executive of the Patients’ Association, a group which advocates for patients, said: “The proposed reduction to three delivery days a week by Royal Mail is deeply concerning from a patient perspective.”
She added: “Royal Mail must ensure these changes don’t hinder shared decision-making by delaying patients’ access to information needed that might impact their treatment and their lives.”
The Royal Mail was fined £5.6 million by the regulator Ofcom in November for failing to meet its obligations on delivery targets.
Delays to medical letter deliveries included appointments for the children of Jasmine Moulton from Cheshire, who had been informed by hospital staff that her son Joshua, three, had missed scheduled surgery to help his breathing and swallowing issues, while her daughter Harper, five, had missed medical appointments for severe skin allergies that require her limbs to be wrapped in bandages, it was revealed in January.
Jacob Lant, chief executive of health charity National Voices said: “The proposals being consulted on risk further delaying vital communications and worsening digital exclusion, therefore unfairly widening health inequalities. NHS mail must remain a priority service.”
A Royal Mail spokesman said the service was “committed to working with a range of NHS bodies to explore options that could provide more reliability for time-sensitive medical letters”.
It said these could include marked envelopes, barcodes and a hybrid product where doctors would decide if it “warrants a speedy delivery”.
He added: “The NHS is complex and made up of hundreds of different trusts and thousands of GP as well as other services, each with varied requirements. Going forward, we will continue to offer them a choice in service levels and pricing, to suit the differing priorities of each part of the organisation.”
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