The challenge
Liverpool Women’s NHS Foundation Trust, is one of two dedicated specialist trusts in the UK solely focusing on the health of women, babies and their families. It serves a highly diverse population, with complex needs shaped by language, culture, accessibility and digital confidence. The Trust realised that language barriers, low health literacy, sensory impairment, neurodiverse needs and digital exclusion meant that communication itself had become an invisible barrier to care, driving health inequality.
This caused:
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High levels of Did Not Attends (DNAs) driven by communication barriers
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Late or missed letters due to postal delays and rigid processes
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Patients unable to navigate appointments or understand care pathways
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Staff time consumed by manual processes, follow-ups and rebooking
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A lack of patient dignity and autonomy where some patients were unable to manage their own care.
“Too much of healthcare technology is designed without understanding the reality of the people who rely on it. By focusing on lived experience and truly listening to our patients, we shifted from expecting them to adapt to our systems, to designing services around their lives and needs. This was more than a technology rollout, it was a cultural and operational shift, embedding inclusion at every stage of the patient journey.”
Paula Brennan
Senior Digital Program Manager and Digital Inclusion Lead, Liverpool Women’s NHS Foundation Trust
The solution
Liverpool Women’s led a ground-up transformation, combining digital innovation with patient co-design to rethink communication. Netcall’s Liberty Converse was already powering the contact centre, so they worked with the team at Netcall to introduce Patient Hub, our patient engagement portal.
Working in close collaboration with Netcall, they created one of the NHS’s first fully operational, end-to-end multilingual and accessible communication pathways. These were not separate services, they were embedded into routine operational workflows, delivering inclusion at scale.
Key elements included:
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Patient engagement via Patient Hub – Digital letters, reminders, appointment management and waiting list validation at scale
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Inclusive, localised communication – Top 10 patient languages identified and deployed (including Arabic, Kurdish, Urdu, Tamil) including languages that read right-to-left, as well as alternative formats like braille, British Sign Language and large print
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Translated letters and SMS
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Patient-first communication – clear information and compassionate, context-aware messaging
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Personalisation and choice on communication preferences
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Data-driven continuous improvement – real-time reporting to identify gaps and underserved groups.
“By embedding inclusion into everything we do, we’ve improved engagement, reduced missed appointments and given patients greater control over their healthcare journey. It’s a fundamental shift in how we deliver care.“
Paula Brennan
Senior Digital Program Manager and Digital Inclusion Lead, Liverpool Women’s NHS Foundation Trust
The result
50,000+
digital appointment communications delivered at just 30% rollout
70% Read rates
digital read and response rates with sustained engagement- up to 80% when including re-reads
32% DNA reduction
in some pathways, 18% reduction on average across all pathways
2 Week validation
waiting list validation completed in under two weeks – manual methods took months or years
£5,000 Monthly savings
on postage costs, projected £60,000 annually due to 68% reduction in letter printing and posting
Multilingual uptake
including increases of
411% growth in Portuguese use, 394% in Romanian and
711% in Arabic
10,000+ Successful patient interactions
where information was accessed, understood and acted upon
Business impact
The Trust transformed communication into a direct intervention on health inequality. Patients who previously faced barriers due to language, disability or digital exclusion, can now access and manage their care independently.
Over 200 patients adopted accessible and multilingual options without promotion, showing real-world impact and un-met demand.
Manual, time-intensive processes have been replaced with scalable digital workflows.
Activities that previously took months, or even years, can now be completed in days or weeks. this significantly improves waiting list management, clinic utilisation and staff productivity.
Staff time has been redirected away from manual administration towards higher-value care delivery.
Clear, fast and accessible communication has directly improved patient behaviour and clinical outcomes.
DNA rates have reduced significantly, with previously underperforming services reaching acceptable thresholds for the first time in six years. There has been a clear improvement in attendance among non-English-speaking patients.
Faster communication – reducing delays from days to hours in some cases – ensures patients receive timely care, which is particularly critical in urgent pathways.
Verified by Liverpool Women’s NHS Trust – July 2026
Scalable health inequalities intervention
By redesigning communication around inclusion, accessibility and lived experience, Liverpool Women’s has surpassed digital transformation to deliver a scalable health inequalities system. The result is patients no longer need to adapt to services: Services adapt to patients.
This work has clearly improved engagement, efficiency and outcomes at the Trust. This is now influencing wider NHS thinking and future implementation models.