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For Primary Care| View from the ground

Texting Patients in General Practice—is There a Better Way to do it?

View From the Ground, by Dr Honor Merriman

As an older person, I am now at a stage in my life when I not only deliver healthcare, but also regularly receive it. Recently, I got a text message from my surgery to let me know that I had missed a phone call from a nurse. I typically leave my phone on when I know that someone needs to contact me, but this time I had been taken by surprise. Looking back, I had not received any notification from the practice that a phone appointment had been arranged. When the anxiety about not responding had passed, it got me thinking about the advantages and disadvantages of using text messages to communicate with patients.

Recently, I reviewed patient records at a practice other than the one at which I work. It was interesting to seethe number of patients who had not spoken to staff at the practice over the preceding year, yet had received up to 20 text messages, most of which they had not responded to. These messages comprised a mixture of recalls for blood tests related to a variety of long-term conditions, and general messages about matters such as the importance of wearing facemasks when visiting the practice. I could imagine how these messages may have confused patients: it may be difficult for patients to differentiate between general information, earlier reminders that they have failed to respond to, and new invitations from the practice.

This highlights a key disadvantage of using text messages to communicate with patients—text message fatigue. Some people don’t respond to texts; it’s not an age thing, they just get so many texts each day that they only respond to what seems most urgent to them. Another disadvantage is that some patients have never really got into texting, and prefer an email, a phone call, or a letter instead. A 2020 report by Ofcom found that just 41% of people use text messages every day.1 I wonder how much we think about this when contacting our patients?

There are many ways to utilise text messages more effectively. Firstly, it is helpful to make a note of patients’ communication preferences in their records when they are asked for permission to be contacted in this way. Secondly, senders should consider if the message is essential—administrative matters that are of high importance to the surgery are often of lower priority to patients.

Increasingly, patients with long-term conditions are being recalled for review by practices according to their month of birth. The patient is invited in for blood tests, and then undergoes holistic assessment by a clinician. This face-to-face evaluation improves communication between clinician and patient, and enables care plans to be agreed upon after discussion. I have heard the argument that this is too time-consuming, but nobody would want to have their car serviced in a piecemeal way(for example, fitting new tyres this week, and replacing the engine oil a month later). The invitation to the review can be sent via text, but if there is no response, this should be followed up with a phone call, an email, or a letter, depending on the patient’s preference.

I asked my family whether they like receiving text messages from their GP practice and, overall, I received a positive response. The text messages they find most useful are:

  • invitations for immunisations (COVID-19 and others) and medication reviews
  • reminders about appointments 24 hours beforehand, with the option to reply if they cannot attend; these are appreciated more if they are personalised
  • notifications of test results, or requests to contact the practice to discuss a result
  • information about a health condition sent after speaking to a GP.

These are just a few reasons why my family, as patients, like receiving text messages from their GP, and there must be many more. There are definitely advantages to using text messages for GP practices: the challenge is to determine how to use the service to best advantage.

For more information on keeping patients informed via text, visit: