Use of SMS for direct patient messaging

SMS messaging is a convenient and effective way for practices to communicate with their patients within seconds. Practices can save a lot of time, by reducing the number of phone calls they make and they can save money, by reducing postage and printing costs.

Although the ICB meet the cost of practice SMS activity – between May – Sep 2022, data shows that the SMS fragment usage by City & Hackney practices was very high - and increasing - but also that it varies significantly between our practices.

Using the text messaging for direct patient communication is encouraged, however, it is important that practices are using SMS messaging appropriately and, where possible, taking steps to help the ICB manage costs.

Appropriate uses of SMS messaging

Appropriate messages include:
-    Administrative information e.g. prescription ready to collect 
-    Care plan sent in a consultation e.g. dosing of new medication 
-    Recall e.g. advising the patient to book an appointment 
-    Advice and safety netting sent in a consultation e.g. link to NHS Choices information or MSK exercise videos 
-    Signposting to third-party services in a consultation e.g. exercise classes
-    Normal test results e.g. Chest x-ray normal
-    Some abnormal results e.g. Low Vitamin D, with advice for sun exposure and OTC supplements
-    Telephone information e.g. you tried to call but could not reach them, or will be calling 
-    Reminders e.g. for cervical screening or overdue blood tests 
-    Follow-up e.g. checking a patient has received a hospital letter after a referral
Inappropriate messages include:
-    Worrying, complex or sensitive test results e.g. STI test or high PSA
-    Long or complex messages e.g. multiple medication changes
-    Links to sensitive patient advice without consent e.g. family planning advice 
-    Signposting to third-party services without consent e.g. Macmillan contact details
-    Critical information without follow-up e.g. urgent appointment required

Guidance for reducing/managing SMS costs

To keep SMS fragment usage to manageable level, it is advised that messages should be kept as short as possible, unnecessary spaces/grammar should be removed and the use of paragraphs should be avoided.
Where 1 message is over 160 characters (including spaces) in length, it requires multiple fragments to deliver:
•    Up to 160 characters = 1 credit/fragment
•    Up to 312 characters = 2 credits/fragments
•    Up to 459 characters = 3 credits/fragments
•    Up to 612 characters = 4 credits/fragments

Tips on how to be more sustainable with SMS messaging  


Useful links for guidance on how to use fewer fragment or credits per message:
-    Attaching documents with additional information: Accurx Desktop: How to attach test results, sick notes, etc directly from your Medical System to SMS messages | Accurx Help Centre
-    Changing the sender ID to avoid using the full practice name when signing off messages: Manage Practice: How to change the text sender ID from "GPSurgery" | Accurx Help Centre

Contact for practices:
If practices need further advice or guidance on how to make better use of the messaging software, they can contact Thomas Clark on