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How we used text messaging to improve access

What we did

Every morning the reception team check the practice e-mail inboxes at both sites for cancelled appointments. These appointments will have been cancelled by patients in response to an automated appointment reminder we will have sent them. Experience has shown that patients tend to respond quickly to text message reminders from the practice, so by timing the sending (of these reminders)  intelligently, it enables us to free up  morning appointments  at short notice, removing the prospect of potential DNAs and replacing them with appointments on the day.

In addition, the service is particularly useful as a reminder of appointment date and time for a section of our patient population that frequently forget they have an appointment booked. We have been using our SMS programme since 2010.

We use a cloud-based service, which means that as practices we do not need to think about technology aspects such as server capacity, maintenance, data breaches and access rights. It is all managed on N3 using NHS approved and routinely monitored providers and processes.


In September we faced the challenge of trying to persuade ‘at risk’ patients to have their seasonal flu immunisation. Failure to have their flu jab means the patient can fall ill, which has a knock-on effect for the practices in terms of increased consultations, higher prescribing of associated medication and in some instances more patients in A&E.  

But we also have patients who know the process and book themselves in for a jab. This is sometimes triggered by a reminder letter but, some patients will ignore letters.  An increase in postage costs led to us looking at other methods of communicating with patients and our targeted text messaging service has proven to be the answer to achieving cost savings and meeting immunisation targets.

Using the practice clinical system we search for at-risk patients who have not yet received their seasonal flu immunisation. We then export the search data and send reminders to at-risk patients. This reminder message prompt immediate patient reaction - they call to book a flu jab, but they also enable us to automatically read code that the invite has been delivered.


We are now able to issue timely appointment reminders to patients who, through the same medium are able to cancel appointments if no longer required. This has the knock-on effect of reducing DNAs as well as freeing up appointments.

It is popular among patients. It provides a more durable medium for reminders than appointment slips of papers. A lot of my patients actually now decline appointment slips in confidence that they will be receiving text message reminders.

Text messaging has proven useful for general health promotion. We have successfully used it for flu jab invitations and also to establish smoking status.

The future

Greenwich CCG recently funded an SMS service on behalf of all practices in the borough for another three years.

Dr Ariyike Oke is a GP in South London. Olu Bankole is the IT lead at her practices.