Reducing the ‘Did not Attend’ rate with digital patient letters.

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0%

Drop in Did Not Attend (DNA) rate.

0%

Reduction in postal letter costs.

£0M

Potential income gains.

Postal letters are the main NHS communication channel for patient appointment details. However, in a recent survey 48%* of respondents who had missed a medical appointment stated postal letter related issues, such as mail arriving too late or not at all, for their non-attendance.

United Lincolnshire Hospitals NHS Trust (ULHT) is one of the biggest acute Trusts in England, covering four hospitals and caring for a large rural community. The Trust went to tender to find a solution to improve patient engagement by capitalising on digital efficiencies in patient communications.

Challenge

Patients missing appointments due to lost or late mail.

Solution

Appointment letters are sent to patient smartphones.

Results

Drop from 5.8% to 4.1% in DNA rate.

Background

In June 2018, The Times newspaper reported that the NHS “wastes £100m a year sending postal letters”. Digital communications are significantly cheaper in every sense with workflow automation, staff time is redirected to more valuable tasks.

  • Patients reported missing appointments due to lost or late mail and there was no real way to track if postal communications were received; this was especially relevant to patients living in rural areas where postal delivery times vary.

  • The end to end process was inefficient, staff were overburdened with postage admin and internal processes were resource heavy and incurred high costs.

  • Considerable capital investment with the internal system. Folding machines were up for replacement, further contributing to letter related costs.

  • The current ways of working did not facilitate compliance with the Accessble Information Standard; translating paper communications into numerous language templates was not financially feasible.

Solution

Smartphone coverage within the UK is 85% and message delivery is instant and trackable, providing the ideal channel to ensure patients receive important appointment details. Webex CPaaS Solutions was the Trust’s chosen supplier based on the proven results and socially inclusive communications their patient portal offers.

How did we help?

  • Patients instantly receive appointment letters straight to their smartphone. Instead of ringing the hospital to reschedule/cancel appointments, patients simply tap a button. With responses reported back to the Trust in real time, reutilization opportunities open up earlier, reducing patient waiting times.

  • Digital content converts to 100+ languages in two clicks, font can be increased and highlighted and background colour changed to improve patient accessibility.

  • Patients can add appointment details directly into their digital calendars as a further reminder.

Real time journey updates

All essential reading and appointment specific information is attached for the patient, and the Trust has visibility of whether this information is read. A real time home to hospital route is included to help with on-the-day travel plans. And if the digital letter is not accessed within 24 hours, a postal version is automatically sent to provide a fully inclusive service.

Results

  • DNAs dropped from 5.8% to 4.1%, one of the lowest in the country.

  • Potential income gains of more than £2 million per year with the reduction in missed appointments.

  • 57% cost savings by decreasing postal correspondence.

  • A reduction in future capital expenditure as folding machines no longer need replacing.

  • Fully compliant with the Accessible Information Standards, enabling patients to personalise communications to their needs.

  • Better use of staff resource. When surveyed, 70% of staff said the new solution is time saving.

59%

of patients choose digital communications over postal correspondence.

Patient behavior insights

With trackable communications, the Trust can now access patient behaviour analytics including open rates, essential reading clicks and which patient portal features are most used. This insight enables the Trust to tailor communications to increase read rates and provides a full audit trail.

  • 36% patients aged 70-89 years accessed the portal, challenging the misconception that certain age groups do not engage digitally.

  • 70% of 18-29 year olds chose digital letters over the postal version.

  • 59% of patients choose digital communications over postal ones.

“
I previously missed an appointment because the letter didn’t arrive until three weeks after the appointment date. I like the fact that I have all the information I need digitally and with sufficient notice of future appointments. ”
Patient, United Lincolnshire Hospitals NHS Trust

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