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NHS must use email by default, says health secretary Matt Hancock

Secretary of state for health and social care criticises NHS staff who insist on only sending letters to patients, and says modern, secure communications will save lives

Health secretary Matt Hancock wants NHS staff to use email as the default method for communicating with patients, instead of relying almost solely on paper letters.

Speaking at the NHS England Empowering people in a digital world conference in London, the secretary of state for health and social care criticised those in the health service who reject the use of secure, modern communication methods.

“We spend £8m a year in the NHS on paper. We spend £2m a year on envelopes. We can save lives, save staff time and cut costs by using an extraordinary piece of technology that has the ability to allow two people to communicate instantaneously… It’s called email, I don’t know whether any of you have heard of it. We’re going to use it across the NHS, not just to communicate internally, but to communicate by default with patients,” he said.

Hancock attacked the reliance on paper in the NHS, reiterating a previous ambition to “axe the fax” that led to a ban on NHS organisations buying fax machines.

“More than half a million letters between GPs and hospitals have gone missing over the past five years. If I need to motivate both the privacy and the operational need to update this outdated technology, that half million figure is right at the top of the list,” he said.

“Of the 1,788 patients who may have been harmed as a result, 333 have since died. We don’t know the direct effect between missing letters and life and death outcomes, but it could be the difference between life and death.”

NHS Digital is publishing new guidelines on making sure email systems in the health service are secure.

“There’s no reason why a doctor can’t email a patient confidentially… as long as the email system is secure. Being able to email a patient is important, necessary and the right thing to do. Snail mail is slower and less secure. In a city like London, people change [home] address more often than their email address,” said Hancock.

People who prefer to receive letters will still do so, but Hancock said the idea that the NHS “shouldn’t use a technology because it can’t be used for everybody is a huge mistake”.

In October last year, Hancock set out his technology vision for the NHS, focusing on modern technology architecture, user needs, privacy and security, interoperability and inclusion. He told NHS staff at the conference that they have to get up to date on what today’s technology can do.

“Of the 1,788 patients who may have been harmed as a result [of missing letters], 333 have since died. We don’t know the direct effect between missing letters and life and death outcomes, but it could be the difference between life and death”
Matt Hancock, health secretary

“We can’t get NHS technology into the 21st century until we catch up with the technologies of the 20th century. There are some people reacting against the use of 20-year-old technology. We are on the side of patients, of security and privacy, of improving and saving lives,” he said.

Predictive prevention

Michael Ekpe, chief digital and technology officer at Public Health England, also talked at the conference about a tech-led initiative called predictive prevention, which aims to gather personal health data from patients to help change their behaviour to improve their health.

The programme is another Hancock initiative that encourages health and social care organisations to explore personalised and targeted digital services based on lifestyle and circumstances, to engage citizens in taking responsibility for their own health.

Ekpe highlighted the importance of the NHS App, which is under trial, and is intended to become the digital front door for NHS services.

“The ambition for predictive prevention is huge, but we need to start small. We have a number of initiatives under way,” he said.

A lifestyle behaviour change programme begins in Manchester in May, which Ekpe said will involve a dialogue with the public to understand what resources the NHS can apply to sustain behaviour change in the long term.

Another initiative aims to digitise the free NHS health check, which includes looking at how to create an online check and investigate ways to collect data and monitor people’s progress on an ongoing basis.

The hope is that patients will agree to share personal data from their own digital devices, such as smartphones or fitness trackers, to complement the health data held by the NHS to encourage people to make changes to their behaviour, such as losing weight, quitting smoking or taking exercise, to prevent health issues. 

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