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NHS Turns To SMS for Appointment Reminders

David Murphy

Mobile messaging company Mediaburst has revealed the results of a pilot programme at Hull and East Yorkshire Woman and Children's Hospital, of an SMS-based patient appointments system. According to Mediaburst, NHS Trusts nationwide are now looking to adopt the reminder service that helps reduce missed patient appointments and resulting losses in hospital revenues.
The Managed Appointment Reminder Service (MARS), aims to help NHS Trusts slash an estimated £614 million out of their operating costs each year due to patient no-shows. The service was developed by wirless application developer Island Communications, in association with the NHS and Mediaburst.
The service is a fully managed solution, which sends out a text message reminder to all patients or customers nominated mobile phone at an agreed date ahead of the forthcoming appointment. On receipt of their Appointment Reminder, patients or customers are able to note the reminder, and then have the opportunity to reply, should they be unable to attend their appointment. Patients who do not have a mobile may nominate the mobile number of a relative, carer or friend to pass on reminders on their behalf.
Hull and East Yorkshire Woman and Children's Hospital’s Paediatric Outpatients Unit was the first to test the system. Providing specialist and general care to children who have been referred to its consultants, around 15,000 outpatient appointments are scheduled by the unit each year. Over 20% of these are missed, however, because outpatients simply forget to attend.
“Clearly, missed outpatient appointments are a prime concern to the unit for a number of reasons, the most important being the health and well-being of the child,” says Paediatric Services Manager, Jackie Timson. “First and foremost, we want to ensure that children under our medical care are receiving the attention and treatment they need to recover fully from any health problems they have experienced. A further concern is the financial impact of missed appointments as PCTs (Primary Care Trusts) do not fund missed appointments. This represents a significant loss to the potential income to the Trust.” 
Like all areas of the NHS, the Unit is constantly striving to maximise its resources so that it can improve the service it offers to the community.  One of its principal aims is to reduce the length of time between a patient being referred into the service to receiving treatment, in line with the Government's 2008 18 week referral-to-treatment target. Because missed appointments usually need to be rescheduled, the end result is delays for other patients, which makes it harder to achieve this aim.
The Paediatric Services Unit uses the MARS service to send a text message to the parents of outpatients several days before their appointment to remind them to attend. Of a sample of patients who were asked whether or not they would be happy to receive this type of reminder, over 90% said they would like to.
Timson says that reminding patients of appointments via the messaging service is playing a valuable part in reducing the number of missed appointments at the unit. “During the last three months, we’ve experienced a noticeable drop in the number of patients who haven’t attended appointments," she says. “In some cases, it’s unavoidable that an appointment will be missed, but because we provide an option to reply within the reminder we send, patients can let us know through the MARS management system if they’re not able to attend and in many cases we can allocate their slot to another patient, which is a further advantage of the system.”
Since the Trust started to use the MARS application, its bank of patient mobile holdings has grown from below 3% to around 30% and senior management have now approved the extended roll out of the MARS application. Since the introduction of MARS, DNA (did not attend) rates have fallen, with good results achieved in all participating departments.
The MARS service has been adopted by Cable & Wireless as their recommended Managed Reminder Service for NHS Trusts, and Island Communications, in Partnership with Cable and Wireless, has recently won a major contract to role the service out to Trusts throughout the UK.

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