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Did you know?

  • Text messaging in Primary Care has revolutionised how practices can get in touch with patients, exchange information and remind patients of appointments.
  • Text messaging from GP practices has increased since the pandemic, however SMS costs have also risen.
  • SMS messaging from Primary Care systems is not free
  • Each SMS is made up of ‘fragments’ – so a message may comprise multiple fragments.
  • Each fragment costs approximately 2.2p, therefore a single complete message with multiple fragments will cost even more. Considering some practices may have 30,000+ patients, costs can soon add up.
  • Primary Care SMS costs in 2022/23 were £340,000, 2023/24  £415,000 and with the same trajectory and SMS price rises, projected costs for 204/25 are over £500,000.

The ICB has initiated  a project to review the use of SMS messaging including the promotion of best practice and a better reporting of activity and costs across Primary Care. Gloucestershire ICB are keen to ensure best practice with SMS usage is in place and that costs & usage can be viewed at practice/PCN levels.

Best Practice for using SMS

  • Take a look at a simple SMS messaging checklist 
  • Costs can be kept down by reducing the length of messages (i.e. ensuring messages are succinct reducing the number of fragments used ) and changing settings in clinical systems such as SystmnOne, EMIS and Accurx to initially send messages to the NHS app (no cost).
  • Accurx gives practices the option to send messages via the NHS app (free) – details available here: Batch Messaging: How to use Batch Messaging with the NHS app | Accurx Help Centre
  • If the message is not read within 8 hours, the message will automatically be sent as an SMS that does incur a charge. Patients should be encouraged to not only activate the NHSApp but also ensure that notifications are enabled within the App.
  • We are waiting for NHS England to publish official guidance on how text messaging can be  best be utilised in Primary Care and tips and messaging template designs to reduce SMS costs. This will be published on here in due course. In the mean time there is some guidance issued by other localised NHS organisations which may be useful (see the links).
  • Check this SMS Count Before You Send Toolkit (2) produced by SCW CSU to understand the practicalities of SMS messaging

Frequently Asked Questions

How in our practice can we potentially reduce SMS costs?

  • Think carefully about the content of your message – try to keep the number of fragments (160 characters) under control – i.e. if you use a single ‘special’ character , @,”, this can reduce the fragment character limit to 70 (from 160)
  • Promote the NHS app to patients/ask them to turn on notifications – AccuRx messages by default will go to the NHSApp at no cost, if the message is unread though (because notifications are not enabled in the NHSApp) an SMS will be sent at a minimum cost of 2.2p and maybe more if multiple fragments are used.
  • Review the frequency of Appt reminders – check with patients if they receive too many/too few reminder messages.

As a Practice, can we request the character length of our text messages to patients be increased passed 308 characters?

There is a two ‘fragment’ limit for Gloucestershire and this can’t be individually changed for each practice. By increasing the size of text messages it will incur further costs. Each message is made up of 160 character ‘fragments’. The cost is for the fragment, not the entire message. A message containg 2 fragments costs 4.4p, 10 fragments 22p etc.

As a practice, how can we send messages via the NHS app to reduce costs?

Accurx gives practices the option to send messages via the NHS app (free) – you can find out how to turn this on via the instructions here:

Batch Messaging: How to use Batch Messaging with the NHS app | Accurx Help Centre

 

Contact: glicb.glosdt@nhs.net