Is the doctor's letter dead? How to use the NHS app across the UK

The Government has announced that smartphones will become the default way the NHS communicates with patients across England - replacing traditional doctors' letters, phone calls and texts.

This month Health and Social Care Secretary Wes Streeting announced the plans to switch to a digital first system with almost all communication via the NHS app. The roll-out will take place over the next three years amid concerns that many older people who don't have access to smartphones, could lose out.

Streeting said traditional communications would still be used as a 'last resort' but Age UK has called for more digital funding to accompany the roll-out to ensure anyone who wants to go online can.

We look at what the changes mean and what is happening in Scotland, Wales and Northern Ireland.

The NHS App in England

Currently more than 11 million people in England log onto the NHS app every month, while almost 20 million are opted in to receive healthcare messages from it.

Once you have proved your identity you can take advantage of the following services:

• Order repeat prescriptions
• Book GP appointments
• View your GP health record
• Book and manage COVID vaccinations
• Register for organ donations.

Those with certain hospitals and GP surgeries can also view and manage appointments, contact GPs and other healthcare professionals, access healthcare for someone you care for and view links.

What the changes will mean

The £50 million upgrade means that over the next three years you will start to receive all your appointment reminders, screening invitations, test results and other notifications directly to your smartphone via the NHS App.

Some 270 million messages are expected to be sent through the NHS App this year - an increase of 70 million on the last financial year, saving an estimated £200 million over the next three years.

In 2023 to 2024, there were around eight million missed appointments in elective care, and around 30% of people missed a screening appointment.

During his announcement Streeting said that smartphone notifications will remind you about upcoming appointments and relay important messages, allowing for faster communication and reducing the risk of these missed appointments.

He said: "This government is bringing our analogue health service into the digital age, so that being a patient in the NHS is as convenient as online banking or ordering a takeaway."

What happens if you haven't got a smartphone?

The Government says that where app messaging is not available, communications will be sent via SMS and then by letter as a last resort - meaning anyone without access to smartphones can still receive messages through traditional routes.

Accessible communications will continue to be supported for those with specific requirements.

But there are concerns that older people will be left behind in this new digital roll-out.

Caroline Abrahams, Charity Director at Age UK called for more funding for digital training programmes.

She said: "This is a big risk so far as many older people are concerned because millions do not use computers at all, or only do so for relatively limited purposes.

"If the NHS app is to become the default means of interacting with the NHS, then this major change must be accompanied by many more opportunities to help people of all ages to go online if they wish to do so - at present these are fairly few and far between so far as older people are concerned. 

"Age UK believes that we must continue to guarantee offline access to public services for all those who don't use computers. The NHS is there for everyone, and it must continue to be accessible to us all, whether we are online or not."

The NHS App in Wales

Wales has its own version - the NHS Wales App. Once registered you can use it to access NHS Wales services such as GP practice online services, NHS 111 Wales health advice and blood and organ donation.

Over the next 12 months the bilingual app will be upgraded, with new functionality including the ability for people to track their place on an NHS waiting list. Patients will also be able to view hospital appointments and access a range of tools to help them manage their health while waiting for surgery.

Speaking at the launch in May, Sarah Murphy, Minister for Mental Health and Wellbeing in Wales, said: “In the coming months, people will be able to track their treatment waiting times, manage hospital appointments all from their phone or device.

“This is just the beginning of our digital transformation, as we work towards creating a digital front door to our NHS and social care services.”

However a spokesperson for the Welsh Government said it is not compulsory for people to use it to access health services.

"Those without smartphones, or access to the app via their internet browser will still receive appointments, screening invitations as they currently do."

The NHS App in Northern Ireland

Currently 160,000 people (8% of the population) use the My Care patient portal in Northern Ireland - this includes the MyChart app.

This initiative began in November 2023 and concluded with the final two Trusts going-live on 8th May 2025. This means all five acute Health Care Trusts are now live on the system.

The platform allows patients to securely access parts of their secondary care records online (hospital or specialist in a community setting), including appointments, medications, and some test results. However you cannot manage GP appointments, get test results arranged by GPs or access other information from primary care services.

A spokespeson for the Department of Health (Northern Ireland) said: "My Care is entirely optional and is designed to empower patients and service users in Northern Ireland, but it will not replace existing communication methods.

"Patients who do not wish to use My Care, or who do not have access to smartphones or the internet, will continue to receive information through traditional methods, such as letters or phone calls.

"Now that all five HSC Trusts are live on encompass, we are actively planning further development of functions within the app."

The NHS app in Scotland

In Scotland the NHS 24 Online app allows users to find their nearest services by postcode or location and get advice on a number of symptoms and conditions.

However in January First Minister John Swinney announced a new Digital Front Door platform, including an app, which will allow people to manage their NHS information online. This will begin to be rolled out at the end of this year.

So far there is little more detail about what features will be available and in March The Sunday Times raised concerns about issues linking the app to doctors surgeries and what will be available on the app when the roll-out begins.