Using behavioural science to improve waitlist validation
Research type
Research Study
Full title
NHS Waiting List Validation: Applying behavioural science and A/B testing to increase patient response rates
IRAS ID
361113
Contact name
Dan Berry
Contact email
Sponsor organisation
NHS England
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
This study aims to improve how the NHS communicates with patients on hospital waiting lists. Many trusts send text messages asking patients if they still need their appointment. If a patient no longer needs it, they can be safely removed from the list—reducing waiting times and helping ensure care goes to those who need it most. However, many patients do not respond, limiting the impact of these messages.
We are working with Calderdale and Huddersfield NHS Foundation Trust and Bolton NHS Foundation Trust to test two versions of these messages. One version at each site reflects the message currently used by the Trust. The other has been adapted using behavioural science principles to encourage more responses.
At Calderdale and Huddersfield, the adapted message highlights the cost of missed appointments to the NHS. At Bolton, the adapted message focuses on the benefit to others—encouraging patients to respond by emphasising that their reply helps someone else access care.
To test which message is more effective, we will run an A/B test. Around 7,000 adult patients on the waiting list at Calderdale and Huddersfield, and around 3,000 patients at Bolton (Gynaecology specialty), will be randomly assigned to receive one of the two messages. We will then compare response rates. There are no extra appointments or procedures involved, and patient care will not be affected.
The study will last for up to two weeks at each site. All patient data will be fully anonymised by the Trusts before being shared with the NHS England research team.
This project will help the NHS improve communication with patients and make better use of appointment slots. The study has not received external funding and is being led by NHS England, in collaboration with both Trusts.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
25/EE/0171
Date of REC Opinion
31 Jul 2025
REC opinion
Favourable Opinion