Hospitals and family doctors across England issued new instructions on Friday after the global Microsoft outage disrupted email and other tools used to arrange care. Several said patients should keep their appointments. Others warned that messages, referral forms and information about medication changes could be delayed.
The National Health Service, or NHS, provides publicly funded healthcare. A referral is a request for another care team to assess or treat someone. A family doctor may send one to a hospital specialist; some services also let people ask for help themselves.
Daylight Post found that reassurance about appointments and warnings about missing referrals appeared side by side in the health service's own notices. A clinic can remain open while the route used to ask that clinic for help stops working.
Requests may need to be sent again
Lincolnshire Partnership, an NHS organization providing mental health and learning disability services, said self-referrals emailed or submitted through its website on November 12 or 13 might not have been received. It asked people to submit the information again once the problem was resolved, and to telephone if the request was urgent.
That notice identifies a different problem from a slower reply. Someone may believe they have joined the queue for care when the service has not received their request. The organization said its teams had plans to protect patient care, while directing urgent referrals from family doctors away from email.
Evelina London Children's Healthcare also told clinicians to telephone referrals needing a response by 5pm on Monday, November 16. It told families seeking advice from their care team to call rather than email.
Its appointments and procedures were continuing. For video appointments, families were told to use the link already sent to them. If they could not access it, a clinician would phone instead. Keeping the appointment depended on a working alternative way to reach the patient.
Messages connect different parts of care
At Ariel Healthcare, a family doctor service in Somerset, the warning covered more than email inboxes. It said the outage could delay online consultation responses, appointment reminders, hospital letters and the preparation or processing of referral forms.
It also warned about information sent when a patient leaves hospital. Those messages can tell the family doctor about a change in medication or the follow-up care a person needs. A delay in that information matters even when the patient's hospital treatment has finished.
Ariel said its website forms used NHS email to deliver submissions. It asked patients to use the NHS App, the health service's patient app, instead of its online form for repeat prescription requests. That was a specific instruction from that practice, rather than a rule for every NHS service.
The Grove Medical Group in Newcastle said its clinical systems were still accessible, but email problems could delay specialist referrals or stop them reaching their destination. It said telephone contact, its online contact service and the NHS App remained available.
These notices describe risks and workarounds at the named services. They do not provide a national count of missed requests or establish how many patients' treatment has been delayed.
An open service still needs a way to reach it
St George's, Epsom and St Helier Hospital Group asked patients and staff to come in as normal, while warning that systems including Outlook and SharePoint were working intermittently. It said calls could involve long waits. The practical instructions therefore varied with the service and the tools it used.
The wider outage also affected public services outside Britain. Australia's Bureau of Meteorology warned that people might be unable to contact it by email, but said forecasts and warnings continued. As in healthcare, the failure of one communication tool did not mean every part of the service had stopped.
For patients, the immediate distinction is between an appointment already arranged and a request still needing to reach a care team. The notices put some of the recovery work on patients and staff: make a call, use a different channel, or send the request again after service returns.
Lincolnshire Partnership specifically asked people not to keep submitting new email or website referrals while the problem continued. Urgent requests needed a phone call to the relevant service.