Our digital-first approach to patient communications

To help make the NHS fit for the future, we are transforming patient communications by embracing a digital-first approach. This means reaching more patients via the NHS App, text messages or email. Eventually, we want all appropriate patient interactions to occur seamlessly and instantly through the NHS App, improving accessibility, efficiency and overall patient experience.

Increasingly, people in England are managing their health digitally. In the 2025 GP Patient Survey, we saw a 5% increase in patients interacting with their GP practices online.

Recognising this and the need to embrace digital solutions, as outlined in the 10 Year Health Plan, we are working to adopt a digital-first approach to patient communications. Going forward, the NHS App will be the primary channel used, followed by text messages and emails. Digital-first does not mean digital-only, and we will continue to send letters to patients who need them.

To boost digital messaging across the NHS, we are focusing on areas where we send a high volume of patient communications, such as vaccinations, screening, GP appointment reminders and questionnaires.

We are changing guidance to NHS providers to encourage them to embrace digital-first solutions in reaching patients. This is reflected in the latest operational planning guidance which states that:

“All providers proactively offer NHS App-first communications to patients (with due regard to digital inclusion), by default through the NHS Notify service”

By the beginning of 2026, we are aiming to send 270 million messages through the NHS App – an increase of 70 million on 2024. Fuelled by increased investment into the app, this could save the NHS £200 million over the next 3 years.

We are working to ensure every patient can reliably receive, understand, and act on NHS communications regardless of ability, access, or circumstance, so that care is safer, fairer, and more effective for all.

Digital-first does not mean digital-only. We will continue to communicate with patients in ways that are comfortable and convenient for them. Our patient messaging is powered by NHS Notify, which helps healthcare providers to identify the best form of communication to reach individuals.

For example, if a patient has the NHS App with notifications turned on, NHS Notify will send messages to the App. If a patient does not have the App, Notify will use alternatives such as email, text message or paper letter. Either way, patients will still receive important information about their health.

Our focus so far

We have designed NHS Notify to:

• allow specific channels to be selected, such as the NHS App, text message, email or printed letter
• provide accessible formats, such as large print, Braille or audio CD
• send translated content provided by programmes for 28 languages
• link to Easy Read and British Sign Language content where it’s available

By ensuring all our digital products meet Web Content Accessibility Guidelines (WCAG), we are improving accessibility at each touch point across the digital service.

In collaboration with NHS health equality teams, we produced Equality Health Impact Assessments (EHIA) for the whole service. These helped us identify the barriers and challenges people face when accessing or responding to NHS messages.

Continuous improvement

By taking a whole service view across messaging and looking across our senders’ services, the ecosystem of messaging technology, message channels, patient experience and health outcomes, we have been able to identify several ways in which we can improve the existing service. In making it more inclusive by removing barriers we are supporting the NHS 10 Year Plan’s focus on improving health outcomes.

Patient engagement and co-design - an ongoing programme of community research where we test and learn from multiple patient groups.

Needs based adjustments - a process to ensure everyone can make adjustments to messaging format and channel to meet their specific needs.

Language translation strategy - outlining our medium to long term translation goals while also exploring options to deliver tactical improvements to the service.

Providers

We are rolling out NHS Notify to simplify sending messages app-first across the NHS, with SMS, email and letter fallbacks. Visit NHS Notify for more information.

Patients

Download or update the NHS App today and turn on notifications to read more messages digitally. Visit NHS App and your NHS account.