NHS trusts risk failing to reach axe the fax target, Freedom of Information requests reveal

NHS trusts risk falling short of meeting the deadline set by health and social care secretary Matt Hancock to “axe the fax” by April 2020, according to the new findings from Freedom of Information requests published today.


A 2018 report from the Royal College of Surgeons made headlines after revealing that NHS hospital trusts in England owned over 8,200 fax machines, prompting widespread criticism of the health service’s reliance on outdated technology.

Hancock later banned the NHS from purchasing fax machines, ordering a complete phase-out by April 2020. “I am instructing the NHS to stop buying fax machines and I’m setting a deadline for getting rid of them altogether. Email is much more secure and miles more effective than fax machines,” he said at the time.

But now, FOI requests submitted by London-based PR and marketing agency Silver Buck indicate that the trusts with the largest number of fax machines have removed only 42% of them during the past year. The request was issued to organisations that had over 200 or more fax machines, based on the data collected by the RCS, and three did not reply.

Findings show that two trusts have even more of the outdated devices in use now, the Mid Yorkshire Hospitals NHS Trust (251, one more than last year) and South Tees Hospitals NHS Foundation Trust (252, two more than last year).

Others, however, have made significant progress. Epsom and St Helier University Hospitals NHS Trust has only three of the gadgets now, only for emergency use, compared to 212 last year.

Newcastle Upon Tyne Hospitals, a global digital exemplar, reduced the number of fax machines by over 65%, and Leeds Teaching Hospitals has removed nearly 55% of them.

“Our biggest challenge has been getting rid of fax machines that are used to communicate externally,” said Sarah Moorhead, associate director of digital demand at Leeds Teaching Hospitals NHS Foundation Trust. “Lots of outside organisations rely on fax machines to communicate with us, and some of them still heavily depend on paper-based solutions where they are yet to start their digital maturity journey.”


Earlier this year, Digital Health reported that a hotel group notified NHS England of a number of faxes accidentally sent to them by GP practices and community pharmacies containing “dispensing tokens (paper copies of electronic prescriptions), certificates and requests for medication,” according to the Pharmaceutical Services Negotiating Committee. At the time, a spokesperson for NHS England told the publication the faxes did not include “any personal information or patient data.”

In 2018, Check Point researchers illustrated how hackers could exploit vulnerabilities in fax machine communication protocols, and would only need a fax number to launch a cyberattack.


In the United States, CMS administrator Seema Verma has also called for an end to physician fax machines by 2020. “If I could challenge developers on a mission, it’s to help make doctors’ offices a fax free zone by 2020,” Verma said during the second interoperability forum hosted by the Office of the National Coordinator for Health IT in Washington in August last year.


“If trusts continue to remove fax machines at this rate, the majority of them won’t be fax-free by 31 March 2020,” said Scott Wilson, EMEA director for J2, provider of internet-based fax technology eFax.

“It’s also important to remember that replacing fax machines generally gets harder the further down the line you get. Trusts start with the easy wins – redundant fax machines and those with low levels of usage. But some fax machines are more important to the way a trust communicates, particularly with external organisations. 

“That’s why it’s so shocking to see that some NHS trusts haven’t even identified a solution for replacing their fax machines. Those trusts need to realise that axing the fax is not simply a case of unplugging your fax on deadline day. It’s much more complicated than that,” Wilson added.

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