Fast and reliable communication is essential across the NHS. Staff need to reach colleagues, share relevant information and coordinate action across busy wards, departments and sites.
Where approved communication systems are slow, fragmented or difficult to use, healthcare professionals may turn to familiar consumer applications such as WhatsApp. It offers instant messaging, group conversations and easy access through personal devices, making it appear to be a practical solution.
However, WhatsApp was designed as a consumer messaging service rather than a dedicated clinical communication platform. Its use can create significant risks around information governance, accountability, access and staff wellbeing, particularly when patient information is shared outside an organisation’s approved systems.
The continued use of pagers and other limited communication methods has contributed to staff finding their own ways to communicate more efficiently.
Pagers usually provide little context and require the recipient to find a telephone before responding. Staff may also struggle to identify who is responsible for a particular role, especially when teams, rotas and locations change throughout the day.
WhatsApp can appear to solve some of these problems. It enables staff to send messages quickly, create groups and share information with several colleagues at once.
The issue is that speed and familiarity alone do not make a platform suitable for clinical use. NHS organisations need to understand where information is being shared, who can access it, how communication is recorded and whether staff are following approved policies.
WhatsApp provides end-to-end encryption, but encryption only addresses part of the security and governance requirements surrounding clinical communication.
The risks depend on how the platform is used, what information is shared and whether its use has been formally assessed and approved by the NHS organisation.
Limited organisational oversight – Consumer messaging groups can be created and managed by individual members of staff, giving the organisation limited control over membership and access.
Former employees, staff who change roles or people who no longer require the information may remain in groups unless they are manually removed. Personal telephone numbers are also visible to other group members.
This can make it difficult for a Trust to apply role-based access, manage users centrally or demonstrate that information is only available to people with a legitimate need to see it.
Incomplete clinical records and auditability – Important conversations about a patient’s care may need to form part of the clinical record.
When communication takes place through personal WhatsApp accounts, it can be difficult to ensure that relevant decisions, advice and actions are consistently documented in the appropriate system.
This limits organisational visibility and can make it harder to review what happened if a patient’s care is later investigated.
Digital Nurse Implementer
As healthcare professionals, we are taught the importance of patient confidentiality very early on in our training. Using Alertive instead of WhatsApp also means that the patient’s care is clearly documented and auditable… Whereas within WhatsApp, we can’t go back and review those.
Accidental disclosure of patient information – Messages can be sent to the wrong person or group, and group membership may not always reflect who currently needs access to the information being shared.
In 2023, the Information Commissioner’s Office reprimanded NHS Lanarkshire after patient information was shared through a WhatsApp group on more than 500 occasions. The service had not been approved by the health board for processing patient data, and some group members should not have had access to the information.
The case demonstrates that relying on staff-managed groups can create significant confidentiality and governance risks, even where the intention is to improve communication.
Use of personal devices and telephone numbers – Using WhatsApp for work can require healthcare professionals to share their personal telephone numbers with colleagues.
This can blur the boundary between professional and personal communication. Staff may receive messages while they are off duty, on leave or trying to disconnect from work.
Chief Clinical Information Officer
Previously, I had to be involved in WhatsApp groups because that was the only method of communication. When I went on holiday, I literally had to uninstall WhatsApp.
Healthcare staff need communication tools that support the realities of shift work and allow them to step away when they are no longer responsible for a role.
NHS organisations need communication systems that combine the convenience of instant messaging with the governance, visibility and controls required in healthcare.
This should include:
Alertive provides a dedicated clinical communication platform designed for healthcare teams. Staff can communicate securely across devices while organisations retain greater oversight of users, roles and communication activity.
Role-based communication also helps staff reach the person currently responsible for a service, rather than relying on personal contact details or manually managed WhatsApp groups.
Auditability provides a clearer record of communication, including what was sent, when it was sent and how colleagues responded. This supports accountability and gives organisations greater visibility over communication pathways.
Staff can also separate work communication from their personal messaging accounts and relinquish roles when they are no longer on shift.
Staff often turn to WhatsApp because they are trying to solve a genuine operational problem. They need a quick and familiar way to reach colleagues and coordinate care.
Simply telling staff to stop using consumer messaging applications will not address the reason those applications are being used.
NHS organisations need to provide an approved alternative that is secure, easy to use and suited to the pace of clinical work. It should enable rapid communication while supporting confidentiality, organisational oversight and staff wellbeing.
Replacing pagers should not require NHS teams to compromise on governance or rely on personal messaging accounts. A dedicated clinical communication platform gives staff the speed and flexibility they need within a system designed for healthcare.
Are staff within your organisation relying on WhatsApp for clinical communication? Speak to Alertive about creating a secure, auditable alternative.
The NHS is considered a world-leader in delivering high-quality, modern healthcare services. When it comes to communication, however, it’s a very different story. The continued use of outdated communication methods like pagers and fax machines across NHS Trusts has driven many clinicians to use consumer messaging platforms, such as WhatsApp, to try and keep up with the demands of their jobs. While on the surface this may seem like a good way to circumvent having to use old tech, the significant risk it poses to patient and staff privacy, security and wellbeing is significant.
Healthcare professionals have historically used pagers to communicate, which, while innovative back in the 80s, are now outdated and inefficient. Bleeps are time-consuming to use, offer limited functionality including only working in one direction, and fail to meet the demands of modern healthcare environments where real-time communication is critical. Despite these limitations, the pager system is still in place across many NHS trusts, which has led some healthcare workers to turn to WhatsApp as a faster, more efficient communication tool.
WhatsApp may look great on the surface, facilitating instant communication in a high-pressure environment where time can be a critical factor. Pagers are slow, and even official communication platforms within the NHS can be cumbersome to use. Information can also be shared quickly, and the platform’s group chat feature allows healthcare teams to coordinate patient care across multiple staff members.
That all sounds good, but the big catch is that WhatsApp wasn’t designed for clinical environments. It lacks essential security features, such as audit trails and role-based access controls, which are critical for ensuring compliance with healthcare regulations. This lack of transparency and audibility makes WhatsApp unsuitable for managing sensitive patient data. The problem isn’t just about functionality; it is about governance and the ethical obligation to protect patient information.
The use of WhatsApp in NHS clinical settings has raised numerous red flags, particularly concerning data security and privacy. In August 2023, the Information Commissioner’s Office (ICO) reprimanded an NHS health board after patient data was shared over WhatsApp more than 500 times, breaching confidentiality. The fact that non-clinical staff were accidentally included in these communication groups, as well as staff who had no need to access the patient data in question, underscores the risk of using such platforms.
Data breaches not only violate patient trust but also expose NHS organisations to significant legal and financial consequences. Between 2019 and 2020, the NHS faced more than £1 million in costs related to breaches of the Data Protection Act. This figure illustrates the high cost of inadequate communication systems, both financially and reputationally.
While patients are at the centre of these concerns, It’s also important to consider the issues NHS staff face themselves when they have to resort to WhatsApp. Having to share your personal number with colleagues, being bothered on the job by irrelevant notifications and not being able to switch off from groups when not on shift impacts wellbeing and work-life balance, making WhatsApp use risky in more ways than one.
At Alertive, we believe that WhatsApp isn’t the solution to the communication problem and that NHS Trusts need a dedicated and secure digital platform to replace it. Here’s why:
The need for auditability in healthcare settings means that any communication platform used by the NHS should be able to track all message data back to the origin.
One of the critical advantages of Alertive is its ability to maintain a full audit trail of all communications. This is a crucial feature in healthcare settings, as it allows organisations to review communication and investigate if a patient’s care is called into question.
As Beth Allen, Digital Nurse Implementer at The Christie NHS Foundation Trust, points out:
“As healthcare professionals, we are taught the importance of patient confidentiality very early on in our training. Using Alertive instead of WhatsApp also means that the patient’s care is clearly documented and auditable… Whereas within WhatsApp, we can’t go back and review those.”
Unlike WhatsApp, which only provides encryption without granular access controls, Alertive adheres to NHS security standards and implements user authentication, ensuring that only authorised healthcare professionals can access data. We have a security by design methodology in place at Alertive to ensure this is at the foundation of everything we do, and think that it shouldn’t be any other way when patient privacy is concerned.
As Helen Pardoe, Chief Clinical Information Officer at The Princess Alexandra Hospitals NHS Trust, notes, health professionals need to be able to “compartmentalise” their work and personal lives—something that WhatsApp cannot offer.
“Previously, I had to be involved in WhatsApp groups because that was the only method of communication. When I went on holiday, I literally had to uninstall WhatsApp.”
The ability to separate work and personal communication is critical for reducing burnout among NHS staff, and Alertive makes this possible by allowing users to sign out when they’re not on shift.
The bottom line?
There’s a way to leave pagers in the past without having to compromise on security, confidentiality and wellbeing, and it isn’t WhatsApp.
Healthcare workers need secure communication methods that are designed specifically for clinical environments.
