Barriers to care: quality of hospital appointment letters

Healthwatch Rochdale surveyed 75 residents and held focus groups to understand whether hospital appointment letters provide the information people need to attend appointments successfully. The report found that almost a quarter of respondents had missed an appointment because they did not receive the notification letter, while many others described confusion about appointment locations, travel arrangements and what to expect at their appointment. 

The most common problems were missing practical information. Over half of respondents said appointment letters lacked parking information and directions to the clinic, while almost half said they did not explain what would happen at the appointment. Many patients were attending unfamiliar locations across Greater Manchester and reported stress, increased travel costs and difficulties navigating hospital sites. Transport information and support for people with disabilities, language needs or limited digital skills were also frequently missing. 

The report found that current communication methods do not work equally well for everyone. Some patients preferred digital notifications, but many older people, carers and people with limited English struggled with online systems. Respondents reported blank letters, incorrect contact details, late notifications and inconsistent communication methods. Several felt the system assumes everyone is digitally confident, has internet access and speaks English fluently.

Healthwatch concluded that improvements to appointment letters could reduce missed appointments and improve access to care. Recommendations included standardising appointment letters across NHS sites, providing clearer parking and travel information, improving support for interpreters and accessible formats, offering patients greater choice in how they receive appointment information, and ensuring communications are designed around the needs of diverse communities rather than a one-size-fits-all approach.