Why is the NHS still using snail-mail?: Email between patients and doctors would be cheaper and quicker, so why isn't it being used, asks the Patient from Hell.
On Christmas Eve, I received two snail-mail letters from the local hospital where I'd had day surgery to remove three nasty lumps a month before. One told me that one of the lumps had not been fully removed. It was dated 12 December, 12 days before I received it. The other was an appointment for me to see the surgeon about this on 29 January. It was dated 20 December, four days before the letter arrived. The hospital is about three miles from my door.
Both these letters seemed sort of urgent to me and I was amazed that any hospital should hand them to the tender care of the Royal Mail in the run-up to Christmas. This is the 21st century, isn't it? But, then I remembered that the NHS does not believe in email as a viable mode of communicating between clinicians and patients.
It would have been nice to receive these letters sooner, as I was due to head off for Australia on 12 January for nearly four weeks. I would have liked to talk to the doctor before my departure. However, it being Christmas time, my repeated attempts to rearrange the appointment by telephone were only successful on 28 December. By then, there was no hope of seeing the doctor before my departure for Oz.
This demonstrated to me that the telephone is by no means a foolproof mode of communication between the NHS and patient.
Yet, it is the only high-speed method available – other than fax, that workhorse of the 1980 and 1990s.
This time last year, I made a similar moan about the NHS being an email-free zone. At that time, I did a quick straw-poll on the websites of my local hospitals and on some of the most prestigious hospitals in the country, to see if any of them were patient/clinician email-friendly. Last month, I repeated the poll. I found hardly any progress in the past year.
Most hospitals give no email address on their main contact page. They give email addresses only for PALS (patient advice and liaison service), job applications and the press office. The only hospital I found last year that allowed email access to named staff was Cambridge Universities Hospital Trust, which also helpfully gives instructions on creating email addresses: firstname.lastname@addenbrookes.nhs.uk. Some outpatient clinics at Addenbrookes also now have email addresses. Last year, the IT manager for King's College Hospital commented on my blog that he was very interested by my article, and he would get advice from Cambridge. This year I find that the King's website, when it asks for patients' contact details, includes a field for an email address. I had never seen an NHS organisation before ask for a patient's email address. It seems as if King's is preparing to make email an acceptable way of communicating with patients. Patients can even communicate by email with the governors. Now, there's a breakthrough!
But the majority of hospitals still stodge along with snail-mail. Their excuse is that the old and sick and poor are not going to be able handle email. That is true, but nobody is suggesting that snail-mail be abandoned for the old and sick and poor. We are now at a stage where the people who can handle email vastly outnumber those who can't. Why should patient safety be jeopardised for the minority? And, as the digital natives grow older, the majority will increase.
The other argument of the anti-email lobby is that email is insecure. Is it any less secure than the Royal Mail? And does it matter for most of the email messages between doctor and patient, if they are insecure? Clearly, correspondence about sexually transmitted diseases and other sensitive matters should be carried out by letter, preferably registered letter. But the vast majority of traffic is more humdrum and doesn't need that level of security.
Why carry on with letters, when something cheaper and instantaneous is available? Yes, there are difficulties with email, and there will be loads of unintended consequences. But surely somebody should sit down and study the pros and cons seriously, without the prejudices of the doctor/patient confidentiality lobby getting their own way all the time.
To me, a simple patient in 2013, having to wait four or 12 days for hospital letters is just medieval. I hope the remains of my lump do not get really nasty during my stay in Australia.
PS. Breaking news. I have been having physiotherapy on my shoulder in my local hospital, and was amazed at my first session that the physiotherapist offered me his email address. No member of the NHS has ever done that to me before. During my treatment, I had cause to engage in a useful email dialogue with him, because it was impossible to contact him by telephone.
I suspect that if clinician/patient email is to spread in the NHS, it will be among the ancillary services such as physiotherapists and pharmacists, perhaps even GPs – humble people with common sense and a job to do. It will not come from the consultants and hospital chief executives, who habitually run scared of electronic progress. Guardian Professional.
On Christmas Eve, I received two snail-mail letters from the local hospital where I'd had day surgery to remove three nasty lumps a month before. One told me that one of the lumps had not been fully removed. It was dated 12 December, 12 days before I received it. The other was an appointment for me to see the surgeon about this on 29 January. It was dated 20 December, four days before the letter arrived. The hospital is about three miles from my door.
Both these letters seemed sort of urgent to me and I was amazed that any hospital should hand them to the tender care of the Royal Mail in the run-up to Christmas. This is the 21st century, isn't it? But, then I remembered that the NHS does not believe in email as a viable mode of communicating between clinicians and patients.
It would have been nice to receive these letters sooner, as I was due to head off for Australia on 12 January for nearly four weeks. I would have liked to talk to the doctor before my departure. However, it being Christmas time, my repeated attempts to rearrange the appointment by telephone were only successful on 28 December. By then, there was no hope of seeing the doctor before my departure for Oz.
This demonstrated to me that the telephone is by no means a foolproof mode of communication between the NHS and patient.
Yet, it is the only high-speed method available – other than fax, that workhorse of the 1980 and 1990s.
This time last year, I made a similar moan about the NHS being an email-free zone. At that time, I did a quick straw-poll on the websites of my local hospitals and on some of the most prestigious hospitals in the country, to see if any of them were patient/clinician email-friendly. Last month, I repeated the poll. I found hardly any progress in the past year.
Most hospitals give no email address on their main contact page. They give email addresses only for PALS (patient advice and liaison service), job applications and the press office. The only hospital I found last year that allowed email access to named staff was Cambridge Universities Hospital Trust, which also helpfully gives instructions on creating email addresses: firstname.lastname@addenbrookes.nhs.uk. Some outpatient clinics at Addenbrookes also now have email addresses. Last year, the IT manager for King's College Hospital commented on my blog that he was very interested by my article, and he would get advice from Cambridge. This year I find that the King's website, when it asks for patients' contact details, includes a field for an email address. I had never seen an NHS organisation before ask for a patient's email address. It seems as if King's is preparing to make email an acceptable way of communicating with patients. Patients can even communicate by email with the governors. Now, there's a breakthrough!
But the majority of hospitals still stodge along with snail-mail. Their excuse is that the old and sick and poor are not going to be able handle email. That is true, but nobody is suggesting that snail-mail be abandoned for the old and sick and poor. We are now at a stage where the people who can handle email vastly outnumber those who can't. Why should patient safety be jeopardised for the minority? And, as the digital natives grow older, the majority will increase.
The other argument of the anti-email lobby is that email is insecure. Is it any less secure than the Royal Mail? And does it matter for most of the email messages between doctor and patient, if they are insecure? Clearly, correspondence about sexually transmitted diseases and other sensitive matters should be carried out by letter, preferably registered letter. But the vast majority of traffic is more humdrum and doesn't need that level of security.
Why carry on with letters, when something cheaper and instantaneous is available? Yes, there are difficulties with email, and there will be loads of unintended consequences. But surely somebody should sit down and study the pros and cons seriously, without the prejudices of the doctor/patient confidentiality lobby getting their own way all the time.
To me, a simple patient in 2013, having to wait four or 12 days for hospital letters is just medieval. I hope the remains of my lump do not get really nasty during my stay in Australia.
PS. Breaking news. I have been having physiotherapy on my shoulder in my local hospital, and was amazed at my first session that the physiotherapist offered me his email address. No member of the NHS has ever done that to me before. During my treatment, I had cause to engage in a useful email dialogue with him, because it was impossible to contact him by telephone.
I suspect that if clinician/patient email is to spread in the NHS, it will be among the ancillary services such as physiotherapists and pharmacists, perhaps even GPs – humble people with common sense and a job to do. It will not come from the consultants and hospital chief executives, who habitually run scared of electronic progress. Guardian Professional.
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