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PUBLIC RELATIONS

Friday 2nd May 2025

Why email still matters: making it work in public sector communications

A CIPR member explains why NHS email campaigns are thriving thanks to a strategic overhaul and how you can apply this knowledge to your comms.

By James Sharp

In an era of social media, messaging apps and video content, it's easy to dismiss email as outdated. However, the data tells a different story – especially for public sector organisations like the NHS. Email remains one of the most effective channels for connecting with patients, staff and stakeholders.

The evidence: email is thriving

Recent UK statistics demonstrate email's continued importance:

As of 2024, there are approximately 51.5 million email users in the UK, representing about 75 per cent of the population.
Email usage in the UK grew by 4.2 per cent in 2023 compared to the previous year.
The average UK adult spends 2.5 hours per day checking emails across work and personal accounts.
Email remains the preferred communication channel for important notifications for 72 per cent of UK consumers.

For healthcare communications specifically:

NHS-related emails have an average open rate of 28.4 per cent, higher than the UK average across industries (20.6 per cent).
Healthcare appointment reminders sent via email reduce no-shows by an average of 29 per cent.
76 per cent of UK patients prefer to receive health information through email rather than physical mail.
Public health campaign emails from trusted NHS sources see engagement rates up to 3.2 times higher than social media posts with the same content.

Case study: Engaging Essex on health and wellbeing

At NHS Mid and South Essex Integrated, we work to deliver support and advice across a wide range of health and wellbeing topics for 1.2 million residents. Our experience during the pandemic fundamentally changed our approach to email communications.

Throughout my time working in NHS communications, I've been a strong advocate for an eMarketing model that allows members of the public to get involved on their own terms. This approach enables people to subscribe to specific health topics that interest them personally, rather than receiving generic health information.

This subscriber-led model has been successfully used by our partners in local government for some time. I firmly believe that health communications should be no different – people should be able to choose how and when they engage with health information that matters to them.

By offering a range of targeted health topics like children's health, mental wellbeing, and health prevention advice, we've created multiple entry points for public engagement. This 'arms-length' approach respects people's autonomy while still providing them with valuable health information they want to receive.

The challenge

We faced several significant challenges:

Important and in-depth topics: We needed to communicate complex health information across six key topic areas, including children's health, mental wellbeing, and lifestyle advice.

Large, disparate audiences: We needed to reach external audiences as well as our primary care network of GPs, pharmacists, dentists, optometrists, and our own staff spread throughout the region.

Reduced workforce: Following reorganisations, our communications team reduced by 65%, making efficiency and automation critical.

During the pandemic, email became a critical tool to get information out quickly and efficiently, and this inspired the way we now use email as a key part of our digital communications. We have also found that our audience prefers to receive information via email, so they can keep the information at their fingertips.

Our approach

We implemented several strategies to maximise our email effectiveness:

Targeted segmentation: We captured geographical location data to ensure personalised messages with the right local information for different areas within our region. We also segmented by interest topics and, for internal audiences, by area of specialism and role.
Cross-channel integration: Email became a pivotal part of our wider communications strategy, which helped steadily grow our subscriber numbers.
Automated campaigns: We set up programmatic automated email campaigns that could run in the background with minimal ongoing resource, addressing our capacity challenges.
Mobile-optimised templates: We leveraged national campaign templates and adapted them for local messaging, ensuring consistent, professional communications.
Analytics-driven improvements: We used engagement analytics to understand optimal sending times and response patterns, enabling data-driven refinements to our approach.

The results

Our strategic use of email delivered impressive outcomes:

Our public-facing campaigns achieve an average 44.72 percent open rate - significantly outperforming the NHS national average of 28.4% mentioned earlier.
Smaller, targeted campaigns (under 1,000 recipients) perform exceptionally well with a 47.23% average open rate and 14.29% click rate, validating our subscriber-led approach.
For a Marie Curie palliative care survey, we achieved a 98% survey completion rate through just two targeted email campaigns (four email sends total).
Clear calls-to-action drive engagement — our blood test survey campaign achieved a 16.77per cent click rate with a 50 percent open rate, demonstrating the power of focused messaging.
Our automated campaigns maintain remarkable efficiency with a 99.31per cent delivery rate and only 0.08 per cent unsubscribe rate, essential given our reduced workforce.
Steady growth in subscriber numbers across all our health topics – since 2021 we have grown our external subscriber base to just shy of 10,000 and see year on year growth.
Despite seasonal variations, we maintain consistent engagement with open rates between 40-47 per cent over the past six months, proving our approach sustains audience interest.
We've run 144 successful public-facing campaigns, with increasing activity (18 campaigns in January 2025 alone), demonstrating our ability to scale effective communications.
Traffic acquisition to our website from email campaigns averages between four and five per cent per annum, with an impressive 51 per cent engagement rate from these visitors.
Improved collaboration between different departments and entities within our healthcare system.
Positive feedback from stakeholders on increased quality of communications.

Our digital campaigns are integral to the success of the ICB. Being able to proactively engage staff and stakeholders and efficiently educate and support residents and patients cuts to the heart of our objectives as an organisation. And we can see the results, not only in our campaign analytics but through the effect they have on services.

Why email works for public sector communications

Email offers unique advantages that make it particularly valuable for NHS and other public sector organisations:

1. Cost-effective with high ROI. Email delivers an average ROI of £42 for every £1 spent across UK industries. For public sector communications, it's 61 per cent more cost-effective than printed materials – critical when budgets are tight.

2. Targeted and personalised. Modern email platforms allow you to send different messages to different groups. For healthcare, this means clinicians can receive updates relevant to their specialty, while patients get information tailored to their needs. Studies show that segmented email campaigns in healthcare settings improve engagement by up to 46 per cent compared to non-segmented campaigns.

3. Measurable impact. Unlike many traditional communication channels, email provides clear metrics on opens, clicks, and engagement. This data helps demonstrate value and continuously improve communications.

4. Building trust through consistency. Email remains the most trusted digital channel for health information according to 67 per cent of UK adults. Regular, helpful emails from a trusted source like the NHS build credibility and encourage healthy behaviours.

5. Supporting multi-channel strategies. Email works brilliantly alongside your website, social media and face-to-face communications, directing people to online resources or reinforcing messages across channels.

Practical advice: Getting more from your emails

Based on my experiences of eMarketing, here are key recommendations for public sector email marketing:

Content that works

Focus on value over volume: Short, focused emails with clear benefits outperform lengthy newsletters.
Use clear, action-oriented subject lines: "Book your flu jab today" performs better than "Winter Health Newsletter".
Make it scannable: Use headers, bullet points and short paragraphs for busy readers.
Include one primary call-to-action: Know exactly what you want the recipient to do.

Technical considerations

Mobile optimisation is non-negotiable: With 68 per cent of UK email opens occurring on mobile devices, responsive design is essential. NHS Trusts that optimised their emails for mobile saw a 34 per cent increase in click-through rates.
Test across devices and email clients: What looks good in your inbox might break in another.
Implement accessibility best practices: Accessibility-optimised emails reach 22 per cent more of the UK population, including those with disabilities who use screen readers.
Respect data protection regulations: Ensure compliance with GDPR and regulatory data governance standards

Strategy tips

Segment your audience meaningfully: Different stakeholders need different information.
Develop a consistent schedule: Set expectations for when emails will arrive.
Test and iterate: Use A/B testing to determine what works best for your specific audiences.
Integrate with other channels: Email should complement your overall communications strategy.

Looking ahead: The future of email in public sector communications

Despite periodic predictions of its demise, email continues to evolve and remain relevant. For public sector organisations, it offers an accessible, cost-effective and trusted channel that reaches across demographic divides.

By taking a thoughtful, strategic approach to email marketing, public sector communication professionals can build stronger connections with the people they serve while making the most of limited resources.

A portrait of James Sharp against a grey background. James is a white man with short dark hair and beard, who wears glasses and a white shirt

James Sharp is specialist communications manager (digital, eMarketing and internal) at NHS Mid and South Essex. He is also a chartered PR and co-chair of CIPR East Anglia.