The NHS will get its own Royal Mail postage class to stop late letters leading to missed appointments.
A barcode system will be introduced to automatically identify, separate and process NHS letters, The Telegraph can reveal.
The special NHS barcodes have been agreed by the health service and Royal Mail after consultation with patient groups, including Healthwatch England, as a way to reduce the risk to patient safety caused by the postal operator’s delivery crisis.
It will mean the letters can be filtered from other post and prioritised, even during times of national disruption such as strikes, or when the Royal Mail is missing its service targets.
A source close to the discussions said it would “help to ensure that NHS letters are delivered on time and the NHS gets the service it pays for” after years of deliveries being delayed or lost.
It comes a year after The Telegraph revealed health leaders’ fears that plans to reduce second-class deliveries would worsen delays and put patient safety at risk, which led to Victoria Atkins, a former health secretary, demanding safeguards to NHS mail.
Late letters are behind two million of the eight million missed NHS appointments each year, according to analysis by Healthwatch, with appointment information arriving by post after the date an appointment was scheduled to take place.
In a letter to Ofcom, the postal regulator, seen by The Telegraph, the NHS and Royal Mail have outlined proposals to ensure medical letters are not collateral damage in the planned overhaul to the universal service.Royal Mail deliveries
First class
The current target is for at least 93 per cent of first-class mail to be delivered within one working day – this will be lowered to 90 per cent under the new proposals. And a new target will be introduced, with Royal Mail expected to deliver 99.5 per cent of first-class mail within three working days of posting. First-class post will continue to be delivered six days a week.
Second class
The current target is for at least 98.5 per cent of second-class mail to be delivered within three working days – this will be lowered to 95 per cent under the new proposals. A new target will require Royal Mail to deliver 99.5 per cent of second-class mail within five working days of posting. Second-class letters will also only be delivered on three alternate days of the week and no longer on Saturdays.
NHS mail
The new NHS barcode will mean medical or appointment letters from hospitals can be prioritised. The barcode will allow for automated identification and processing of the NHS letters so that they can be dispatched quickly, ensuring they are part of the day’s deliveries, rather than being left at the depot with other late letters as has been the case previously.
The postal operator is planning to cut its second-class deliveries from six days to three and scrap Saturday deliveries amid concerns that a reduction in letter sending has made the service financially unsustainable.
The plans will see NHS mail given digital barcodes that distinguish them from other letters.
“We have mutually agreed to the introduction of a new Royal Mail NHS-specific barcode,” the letter, co-signed by NHS and Royal Mail leaders, read. “Where Royal Mail quality of service performance targets are not being met, this barcode will mitigate the impact on NHS letters by helping to optimise their delivery at times of local and national disruption.”
Wes Streeting told The Telegraph that the “agreement will help ensure patients get their appointment information when they need it”.
He added: “Too many patients have experienced the frustration of missing appointments because NHS letters arrive too late in the post.
“As we modernise the NHS and upgrade the NHS App, I’m aware that some patients will always prefer letters.
“The important thing is that people have a genuine choice. This agreement will help ensure patients get their appointment information when they need it, however they choose to receive it.”
Currently, NHS hospital trusts can choose to send patient letters via first-class, second-class or “bulk” mail, which is used by large organisations, but the process varies across the country. In some places, Royal Mail staff are manually pulling out NHS letters to prioritise them.
While the method NHS trusts send the post by will remain up to them, the new barcode system will automate the extraction process and, in theory, increase the number arriving on time.
The letter to Ofcom, which was also signed by patient groups, said there was “no standardised approach” to delivering NHS mail but this plan would “ensure NHS organisations continue to have a choice of both price and speed”.
‘Frustrating admin issue’
The postal regulator closed its public consultation to reform the universal postal delivery service on Thursday, with changes to be announced this summer.
Louise Ansari, the chief executive at Healthwatch England, said delayed medical letters were a “frustrating admin issue” and that research showed “one in five people received an invitation to an appointment by letter or text after the date of their appointment”.
“Whether missing important appointments or vital test results, letters arriving late can be a patient safety risk, and often puts the burden on people to chase essential communications themselves. We hope these changes lead to improvements for patients and NHS teams,” she said.
Prof Sir Steve Powis, the NHS medical director, said: “The establishment of the new NHS-specific flags will help ensure that patients always receive the vital information necessary for them to access NHS services they need, as quickly as possible and even in times of disruption.”
Saffron Cordery, the interim chief executive of NHS Providers, which represents hospital leaders, said it was “important that letters reach people on time so they aren’t missing appointments or at risk of losing their place in the queue for care, and not everyone can go online or has a smartphone”.
In December last year, Royal Mail was fined a record £10.5 million for missing first- and second-class targets after years of late letters and no sign of improvements. Bosses have blamed the poor quality of service on its ailing financial performance after it posted losses of £348 million last year.
On Wednesday, it said it would be too expensive to guarantee virtually all first-class letters were delivered within three days amid proposals from the regulator to set a target at 99.5 per cent.
Weeks away from takeover
The postal operator is also weeks from completing its long-awaited takeover by Daniel Křetínský, the Czech billionaire, almost a year after the £3.6 billion deal was first agreed.
Emma Gilthorpe, the Royal Mail chief executive, said: “We understand the vital importance of NHS letters to all our customers. We have put the needs of the NHS at the heart of our universal service reform proposals, ensuring we can deliver a range of service options for appointments and results sent by GP surgeries, NHS bodies and hospitals across the country.
“We have also been working with NHS providers and patient groups to ensure the timely delivery of identifiable medical letters and welcome the truly collaborative approach taken.”