Ad description

A direct mailing from Bluecrest Health Screening received during October 2015 consisted of a four-page letter, which was headed “HEALTH SCREENING APPOINTMENT INVITATION [name]”. Underneath a box was headed “Your nearest Health Screening appointment” and gave a day and location. Further text stated “IMPORTANT INFORMATION ABOUT YOUR HEALTH SCREENING” and “Dear [name], I’m pleased to invite you to a Health Screening Clinic we are holding at the Novotel London West on Friday 6 November. I [sic] would be most useful if you could telephone us on [number] as soon as possible as there are only 20 places available on the day”. The mailing went on to give information about what tests the screening included. Text at the end of the letter stated “My staff will look forward to seeing you. All you need to do is freephone [number] to confirm your actual appointment time on the day”.

The envelope for the mailing was personally addressed, and the name and address appeared in a handwriting-style font. A Bluecrest Health Screening logo was printed in the top left-hand corner, and a printed image of a second class stamp appeared in the right-hand corner, with “Delivered by Royal Mail” written next to it. The bottom left-hand corner featured a QR code and barcode-style device. The back of the envelope included a return address for “Bluecrest Response”. Along with the letter, three inserts were included: one featuring testimonials; an “ABOUT YOUR HEALTH SCREENING” Q&A document and a flyer giving some price information and referencing a special offer.


Two complainants, who believed the mailing was not obviously identifiable as a marketing communication and that it implied an appointment had already been made for the recipient, which they were required to respond to or attend, challenged whether the ad was misleading.


Bluecrest Health Screening Ltd said they had made changes to their direct mailings following a previous informally resolved complaint with the ASA, and that they were willing to make further changes. They said the screening they offered was relevant for any adult between 18 to 78 years of age and that when sending direct mailings they typically wrote to people around the age of 60 to invite them to a screening in their local area. They said they produced a comprehensive direct mail pack to ensure consumers were informed about what they offered, and that it was important to consider the full contents of the mailing, including the three inserts as well as the letter. They said customers would have to speak to a customer advisor before being able to book and attend an appointment, which was why the letter explicitly referred to an appointment invitation. It would therefore not benefit them to imply that no such booking process was required. They said that text in the “Why have I been invited?” box in the letter made clear that it was not compulsory to attend and that booking was required. They said the FAQ insert also made clear that this was a service for which payment was required. They said that at the end of the letter they referred to the mailing as direct mail, where they explained how to be removed from their database. They also said that the envelope included their logo and necessary barcode for delivery. They therefore believed that when all the elements of the mailing were considered, it was clear that it was a marketing communication. They said their costs were made clear and that they also encouraged consumers to compare their service with that of other providers.



The ad had been targeted at consumers around the age of 60 and the ASA therefore considered how it would be understood by an average consumer of around that age. We understood that various NHS health screening programmes were offered to people within that age group including: breast screening for women aged 50 to 70; bowel cancer screening for men and women aged 60 to 74; and abdominal aortic aneurism (AAA) screening for men in their 65th year. We therefore considered that the average consumer in that age group would be more alert to the possibility of being contacted regarding health screening. We also considered that whilst consumers might generally expect such letters to be NHS branded, given the changes in the health sector regarding the privatisation of some NHS services, the fact a mailing was not NHS branded did not rule out consumers being misled by it.

The CAP Code required that marketing communications were obviously identifiable as such, meaning that consumers should be able to tell from the envelope itself that it was a marketing communication. Considering the overall impression of the envelope we did not consider that it was obviously identifiable as a marketing communication. Elements that contributed to this misleading impression included: the use of a realistic looking printed stamp in the top right-hand corner; the use of handwriting-style type for the recipient’s name and address; and the barcode in the bottom left-hand corner. We also considered that the Bluecrest Health Screening logo in combination with the other elements was likely to encourage recipients to open the envelope by implying that it contained information about a health screening programme.

Notwithstanding that we did not consider that the envelope was obviously identifiable as a marketing communication, we also considered whether the contents of the mailing were misleading. The first part of the mailing which would be seen by recipients was large text referring to A “HEALTH SCREENING APPOINTMENT INVITATION [name]” and underneath a box was headed “Your nearest Health Screening appointment” and included a day and location. Text in the box also said to call a number “to confirm your time” or to text a specific number. We considered that the initial impression of the letter therefore implied that an appointment had already been made for the recipient which they were required to respond to or attend. The use of the word “appointment” particularly contributed to this. Further text within the letter used similar language implying a response was required, such as requesting that recipients call “as soon as possible”. We also noted that the third paragraph of the letter included instructions about not eating before the appointment, before then explaining what would happen during the screening appointment. The letter gave extensive information about what would be involved in the screening and what tests would be carried out, but did not make any reference to the fact that payment was involved (apart from one testimonial which referenced “value for money”). We acknowledged that the inserts made reference to prices and payment being required, indicating that attendance or response was not required, but overall we considered that the mailing presented that material information in an unclear and ambiguous way and that it therefore misleadingly implied an appointment had already been made for the recipient which they were required to respond to or attend.

We concluded that the ad was not obviously identifiable as a marketing communication and was misleading.

The ad breached CAP Code (Edition 12) rules  2.1 2.1 Marketing communications must be obviously identifiable as such.  and  2.3 2.3 Marketing communications must not falsely claim or imply that the marketer is acting as a consumer or for purposes outside its trade, business, craft or profession; marketing communications must make clear their commercial intent, if that is not obvious from the context.  (Recognition of marketing communications) and  3.1 3.1 Marketing communications must not materially mislead or be likely to do so.  and  3.3 3.3 Marketing communications must not mislead the consumer by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that the consumer needs to make informed decisions in relation to a product. Whether the omission or presentation of material information is likely to mislead the consumer depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the marketer takes to make that information available to the consumer by other means.
 (Misleading advertising).


The ad must not appear again in its current form. We told Bluecrest to ensure that future mailings were obviously identifiable as marketing communications, and that they did not imply that an appointment had already been made for the recipient which they were required to respond to or attend.

CAP Code (Edition 12)

2.1     2.3     3.1     3.3    

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