The Department of Health is encouraging GPs and hospitals to use NHS Choose and Book and secure text messaging to manage referrals and appointment reminders during the postal strike.

A DH spokesperson told EHI Primary Care that there were other ways of communicating with patients without using the post, including Choose and Book, email and text messaging. She said use of such methods could “quite possibly” increase during the strikes.

She added: “The Choose and Book system is an electronic referral and booking system that enables notification of first outpatient appointments. It does not require the use of the postal system. This speeds up the process of GP referrals to specialists in secondary care.”

The DH said an increasing number of hospital trusts were also using features such as SMS messaging to send reminders and other communication to patients.

The spokesperson added: “On average 20,000 SMS messages are sent via NHSmail every day to reduce appointment no shows as well as communications such as flu jab reminders.”

Delivery and collection workers at Royal Mail last week held two 24 hour strikes and further strikes are due to take place this week, starting on Thursday 29 October.

The strikes have also led to fears that the swine flu vaccination programme may be disrupted.

Chief medical officer Sir Liam Donaldson told a briefing in London earlier this week that the Dh was “a little bit worried about the postal strike because GPs send their letters out, letters of appointment, so we are working very hard to try and get around that, ensuring that people get their appointments in time."

Some doctors are understood to be already considering sending text messages and emails to patients to invite them for the swine flu vaccination rather than letters.

Professor Steve Field, chairman of the Royal College of General Practitioners, said doctors would work hard to get hold of their patients during the strike.

He added: “In the short term – if it’s only for a day or two – we will manage, but what will happen is that we won’t be able to get to people consistently. It will also mess up the system because we will be planning to bring people in sequence.”