Written by Jackie France, Associate Director for Patient Services at NLAG. Part of our ‘Voices of the NHS’ series. 


The elective care backlog is one of the biggest challenges faced by the NHS, with national figures surpassing 7 million for the first time in October.

If we are to succeed in reducing waiting lists, patient communication and choice must be prioritised and the NHS App is at the heart of this. Jackie France, Associate Director for Patient Services at Northern Lincolnshire and Goole NHS Foundation Trust (NLAG) explains all.

Missed appointments are something that the NHS can ill afford. If we are to combat the elective care backlog, it is critical that every single appointment is used to the best effect. To do this, we must place our patients in control of their own care. We need to be more transparent – particularly when it comes to waiting times – and  ensure that patients can easily see and manage their own appointments.

At NLAG, we have worked hard to tackle our backlog and are proud of what we have achieved. Our success is down to our strategies of targeting patients waiting the longest and those that are high risk while simultaneously ensuring that our clinicians are able to maximise capacity by reducing DNAs and any unnecessary appointments.

Through Healthcare Communications Patient Engagement Portal, we have sent more than 500,000 appointment letters digitally since the service went live in June 2021. Digital communication has many benefits: there are no time delays as the communication can be delivered instantly; it avoids letters being sent to the wrong address; and it saves money. We have since also introduced SMS to send appointment reminders which enables patients to cancel or rebook their appointment if necessary – a service which saw an immediate reduction in DNA rates from 10% down to just 7%.

It is these digital services that have helped us as a Trust to meet NHS England’s target to ensure that no one will wait longer than two years for treatment, unless they choose to. This is also why we have been chosen as one of a handful of Trusts to work with NHS England on a national initiative to provide patients with an end-to-end timeline of care in their NHS App or on NHS.UK. You may question why, when we are seeing such success with digital communications, we wanted to be part of this new initiative?

Yes, we have seen success – 66% of our patients are accessing our patient engagement portal, which is above our initial target of 60%, and we have captured 73% of mobile numbers, again, above our target of 70%.

We have also been carrying out surveys to measure the impact that our digital communication is having and to check satisfaction levels and so we know that it is popular with our patients. One of our patients shared his delight that his letters could be read aloud via the patient portal, granting him privacy for the first time as it meant he no longer had to rely on a family member to read the paper letters. Another told us how he was able to reschedule a long awaited consultant appointment that was scheduled during a holiday. The notification arrived digitally while he was abroad and so he could easily reschedule meaning he didn’t miss the appointment and his care wasn’t unduly delayed.

But we want to further increase the number of patients opting in to receive their communication digitally and we think we can do this via the national initiative. The project, known as Wayfinder, is designed to transform the way patients can see and manage their appointments, referrals and, in time, their test results and waiting times. The number of NHS App users spiked dramatically during the COVID-19 pandemic, as many people downloaded the app to access their COVID Passport. This increase in users has made it a more viable way to communicate with patients and we hope that those patients, who may be reluctant to download our patient portal, may be more accepting of accessing appointment information via an existing app on their phone.

The initiative is designed to be vendor-agnostic, with multiple suppliers working together, alongside NHS England, to provide a consistent service delivered through the NHS App. Our patient engagement supplier, Healthcare Communications, is working closely with the NHS England project team to integrate our existing portal seamlessly within the NHS App. We are going live with the first phase of the project at the end of February, which will see all outpatient appointment details accessible digitally via the NHS App and will provide patients with the ability to book or reschedule appointments.

We hope that in future, our digital patient engagement portal will help us to provide increased personalised care for patients, helping us to plan their care with them. It will ensure they know where to go and when, provide clear information on how long they’ll wait and that they understand who to contact if they need support. We know that we will never reach 100% of patients digitally, as there will always be an element of digital inequality in some pockets of society, but we hope to reach the largest portion of our patient population that we can so they can reap the many benefits that digital communication can provide. Afterall, we owe it to them to deliver the best possible care and good communication is an enabler of this.

We are planning to extend our offer of digital letters during the spring and summer to patients attending for admissions and diagnostic appointments.