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Hybrid mail could spell the end for old-fashioned hospital appointment letters

Image shows rheumatology manager Paula Phillips smiling.

The writing could soon be on the wall for thousands of appointment letters Swansea Bay mails out to patients every year.

Sometimes these letters get lost in the post or arrive too late, which means appointments can be missed. They also come at a cost – both in financial and environmental terms.

Above: rheumatology Service Support Manager Paula Phillips says the patient portal allows people to self-manage their conditions

Now the health board is piloting an alternative to the traditional routine of sending letters by surface mail.

People who have signed up for the Swansea Bay Patient Portal (SBPP) will be able to access appointment letters online immediately. Only those who do not open the digital version will be sent a hard copy by post.

This is known as hybrid mail and is being managed on behalf of Swansea Bay by a specialist company, Synertec Ltd.

Although the pilot has only recently started, analysis shows that 88 per cent of all uploaded letters have been read within 48 hours.

The pilot involves rheumatology outpatient appointments at Neath Port Talbot Hospital but, if successful, could expand into other specialties.

When patients sign up for the SBPP, a secure online record is created that allows them to view their blood test results and clinical documents, as well as being able to tap into a library of information and resources.

They can do this via their mobile phone, tablet, or other devices. They can also update their health data and sync with wearable tech like Fitbits.

As family members and carers have an important role, the system allows them to help manage the care, with the patient’s permission.

Blood results and clinical documents can be viewed and shared not only with relatives but clinicians and professionals anywhere in the UK.

It can help reduce paperwork and unnecessary GP correspondence, and within some services it also allows clinicians to free up more clinic time for other patients.

Powered by Patients Know Best, the portal is used in 25 specialities across the health board. And rheumatology, which has championed the portal, has now gone live with the hybrid mail pilot.

Tracy Johns (right) is a relative newcomer to the SBPP, having signed up for it a few months ago while under the ongoing care of the dermatology service.

Tracy needs regular blood tests and receives the results via the portal, which she can also use to order medication.

However, Tracy was recently referred to rheumatology, which is why she was one of the first people to be contacted using hybrid mail.

“I had a letter through the portal asking me to call to make an appointment,” said Tracy, who lives in Clydach.

“I rang, left a message and they called back the next day with the appointment date. It was all done within 24 hours, which was fantastic.

“I think it’s great, and so easy to use. I don’t work with computers and if I can do it, anyone can.”

As of last month, the SBPP has been made available to 14,422 patients and 696 staff.

Digital Services Senior Project Manager Matthew Arnold said hybrid mail was a safe and secure alternative to surface mail.

“Once Synertec receive the appointment letter from us they make a digital call to Patient Knows Best to see if the patient has signed up for the SBPP.

“If so, the patient receives an email informing them they have an appointment letter and asking them to log in,” said Mr Arnold.

“Once they read the letter, Synertec will get an electronic notification from Patient Knows Best and the letter will not be printed and posted.

“If after 48 hours there is no read receipt, a physical print is generated and posted to the patient.”

Patients who have not signed up for the SBPP will continue to receive physical letters.

There are numerous advantages with electronic versions. For example, patients can decide whether they want their appointment letters in Welsh or English, and in what font size.

A hybrid mail system also ensures improved and more consistent communication which in turn will help the health board meet the needs of individual patients.

It will reduce confusion from lost or late letters, or those arriving in the wrong order – which should translate into fewer missed appointments. 

It will also save money and help the environment by reducing the amount of appointment letters posted.

The system will detect if there is more than one letter for a patient and put them in the same envelope.

Service Support Manager Paula Phillips was instrumental in the roll-out of SBPP in rheumatology, where it has gone from strength to strength.

Paula said the portal allowed people to self-manage their conditions. “They can now receive their appointment letters quicker via the portal and use the message feature to amend or cancel the appointment.

“This ensures clinic appointments are optimised and the health board are working towards improving the green agenda.”

Mr Arnold said the outcome of the pilot would be assessed. “If it is successful, the aim would be to roll it out in other specialties across the health board,” he added.


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