SMS messages to reduce missed appointments in hospitals

  • Research type

    Research Study

  • Full title

    To test the most effective reminder SMS message to minimise the rates of missed appointments in outpatient clinics.



  • Contact name

    Anna Sallis

  • Contact email

  • Sponsor organisation

    Department of Health

  • Research summary

    This study is to test content of the most effective SMS reminder message to reduce missed appointments in outpatient clinics.

    Over 6 million out-patient appointments are missed each year in the NHS (about 8.5% of the total). Non-attendance results in economic loss, administrative problems and poor patient care. In 2008 it was estimated that missed outpatient appointments cost the NHS around £600 million a year.

    A systematic review of telephone and SMS reminders found that they significantly improved attendance. A Cochrane Review on the topic found relatively little robust evidence so far, but that which does exist indicates that SMS reminders offer a flexible, effective, cost-effective means of increasing appointment attendance.

    While many NHS organisations already use SMS reminders, we believe they can be made more effective by improving the messages they contain. However, there is currently no evidence for which text messages are most effective

    We propose to collaborate with Barts Hospital to test different text message invites and reminders to reduce missed appointments. These messages will draw on the latest evidence of how message content can influence behaviour. We believe this is an opportunity for Barts Hospital – and other hospitals – to improve outcomes at little or no additional cost.

    We propose the following:
    - To select five clinics where the missed appointments rate is relatively high.
    - To introduce three or four new text messages, which would be randomly allocated to individuals within each speciality. The new text messages will not exceed 160 characters, thus avoiding any additional cost
    - To gather and analyse data on whether the patient attended their appointment, linked to which SMS they received. The data would be gathered between July and October 2013.
    - To report the findings to Barts Health NHS Trust and write-up the study for peer reviewed publication

  • REC name

    North West - Liverpool Central Research Ethics Committee

  • REC reference


  • Date of REC Opinion

    28 Jun 2013

  • REC opinion

    Favourable Opinion