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Emergency measures are being drawn up to protect patients ahead of the national postal strike.
Hospitals and GP surgeries are looking at ways to minimise the disruption, including phoning people with appointment details and employing couriers to carry test results.
Doctors are also considering using text messages and emails to contact vulnerable patients due to have the swine flu vaccination next week.
Chief Medical Officer Sir Liam Donaldson said he was concerned that those eligible for the H1N1 jab - including those with serious medical conditions and all pregnant women - would not receive letters from their GPs.
He said this could put millions of vulnerable people at risk.
"GPs need to send letters out to patients," he said. "[A strike] would be an extremely unwelcome piece of timing. We need to get people into GPs' surgeries to give them this life-saving vaccine."
Today patients groups said the mail mountain caused by any strike would cause anxiety for people across the country.
Michael Summers, vice chairman of the Patients' Association, said it would be especially worrying for anyone waiting to receive diagnostic tests for illnesses such as cancer.
"It is worrying enough for patients, made much worse if they have to wait longer to receive the information," he said. "I hope the health service is alive to these problems."
The Department of Health said it was helping primary care and hospital trusts make contingency plans.
Union members are still in discussions with Royal Mail management but if the walkout goes ahead about 120,000 staff will be involved tomorrow and on Friday.
