Patients Association - Joint letter to Ofcom from Royal Mail, NHS leaders and patient bodies sets out new protections for NHS letter delivery

11 Apr 2025 09:18 AM

We've joined with Royal Mail, NHS England, NHS Providers, Healthwatch England, and National Voices to write a joint letter to Ofcom. The letter explains new steps being taken to make sure patients receive important NHS letters on time.

The announcement comes as Ofcom, the UK's communications regulator, finishes its public consultation on the future of the postal service. A decision is expected this summer.

NHS and patient organisations, including the Patients Association, have worked closely with Royal Mail during the consultation to make sure changes won’t negatively affect patients, especially those who rely on letters for information about their care.

The new measures include:

In the open letter, we and our partners explain how we’ve worked together to protect patients' needs and ensure future changes to the postal service are fair and supportive of patient care.

Rachel Power, Chief Executive of the Patients Association, said:

“For some patients, receiving timely written correspondence is extremely important to their care experience. When information flows as it should between patients and healthcare providers, it creates the foundation for genuine shared decision-making and more effective, safer care that works for all patients. We're committed to ensuring patients receive important health information in the way that works for them without delay. When patients and providers can communicate effectively and reliably, everyone benefits from safer, more personalised care."

The full open letter can be read below.

Open letter to Dame Melanie Dawes, Chief Executive, Ofcom

April 10 2025 

Dear Ms Dawes, 

As Ofcom consults on proposals to reform the universal postal service, Royal Mail, NHS England, NHS Providers, Healthwatch England, National Voices and the Patients Association are writing to set out how we have been working together to ensure that any changes do not lead to worse outcomes or experiences for patients, and that the needs of the public and NHS organisations are met. 

Reform of the universal service

Reform of the universal service The Ofcom consultation sets out why change is needed to modernise the postal service whilst protecting the choice of price, speed and reliability for everyone across the country. Alongside reforms to protect the financial sustainability of the universal service, Royal Mail is also working to drive improvements in quality and reliability of services to meet the needs of all postal users. 

The importance of NHS letters 

There is an increasing move towards digital NHS communications via email, texts, telephone or the NHS App. However letters remain crucial, particularly for those who may be digitally excluded for a variety of reasons. 

The late delivery of NHS letters puts people at risk of missing important test results, time-critical appointment information, and any last minute changes to their appointments. Along with patient safety risks, missed appointments are costly to the NHS and disrupt the delivery of care to other patients. 

While we recognise that public feedback to Healthwatch England, National Voices and the Patients Association highlights experiences of people in England not being sent important NHS correspondence in a timely fashion, we also want to set out the work being done to deliver for the NHS and patients. 

Delivering for the NHS and patients 

Since Ofcom published its call for input on the future of the universal postal service in January 2024, we have been working together to understand the impact of the proposed reforms to the postal service and to ensure that these changes deliver for the NHS and patients. NHS organisations use a wide variety of postal services, with no standardised approach. Royal Mail and the NHS have therefore been working together to ensure NHS organisations continue to have a choice of both price and speed when sending letters, and to improve how NHS letters are sent to patients across the UK. 

Reliability is of vital importance to NHS providers and patients, and whilst all mail is important, not all is urgent. NHS providers recognise that they must ensure they are sending patients’ post out within the right timeframe and it is up to them to determine what service they use to enable that. 

To help with this, NHS England and NHS Providers have produced guidance for NHS organisations, including a case study, to increase awareness and uptake of the variety of Royal Mail services for the timely delivery of NHS letters. 

We are also pleased to announce that we have mutually agreed the introduction of a new Royal Mail NHS-specific barcode. 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. 

Next steps 

Ofcom has set out its regulatory process on universal service reform, with a decision expected in summer 2025. 

While we are not pre-empting any decisions Ofcom may make, we, the undersigned, will continue to look at ways to improve how we work together to ensure that any reform reflects the needs of the NHS and patients. 

Our priority remains that NHS patients receive their post on time and ensuring the NHS has a choice of price and speed of delivery. 

Yours sincerely, 

Emma Gilthorpe, Chief Executive, Royal Mail 
Chris Hopson, Chief Strategy Officer, NHS England
Saffron Cordery, Interim Chief Executive, NHS Providers 
Louise Ansari, Chief Executive, Healthwatch England 
Jacob Lant, Chief Executive, National Voices 
Rachel Power, Chief Executive, The Patients Association 

Cc. Wes Streeting MP, Secretary of State for Health and Social Care 
Jonathan Reynolds MP, Secretary of State for Business and Trade