Text warning

The scene


Before introducing this service, the practice had provided information to patients by way of posters in the waiting room and within the practice leaflet, and had also asked patients to complete a specific consent form outlining the services that would be provided and allowing the patient to opt in or out of each service.

One mid-week morning, a young female patient attended the surgery and was seen by her usual GP in relation to a chesty cough. The patient had a complex medical history and was a frequent attendee at the surgery. This particular GP had supported her throughout some difficult periods. He felt that he knew her well and that they had a good doctor-patient relationship.
During the consultation, the GP prescribed antibiotics and suggested that she return for review at the end of the week if she was no better. By the end of the busy Friday afternoon clinic, the GP had not heard from the patient so thought he should call to check all was well. Realising that a call might be lengthy, and knowing that this patient had signed to accept text messages, he texted her. In his message he asked if all was fine, suggested that she call him if she had any concerns and wished her a good weekend. He signed the text with his first name.

The patient was very surprised to receive the text message. She felt that the consent she had provided did not cover such circumstances and that the wording used was too familiar. She complained to the PCT. On hearing of the complaint, the GP rang the MDU advisory helpline for advice.

MDU advice


The MDU adviser explained to the doctor that, when seeking consent from patients to provide information via a text messaging service, the practice must ensure that they explain clearly the nature of the information that would be texted. This is particularly important because a patient may not be the only person who has access to their phone, and a screen may be viewed by others. The adviser added that the practice must also make certain that even where a patient has opted in to such services, they are used only for the purposes and types of communication originally intended.

The MDU advised the doctor in relation to a written response to the PCT and subsequently in preparing for a meeting between the patient, the GP and a PCT facilitator in which the GP apologised for texting the patient rather than phoning and for using language that was too friendly and informal, and open to misinterpretation. The matter was also discussed at a practice meeting. The incident provided a salient reminder that clear boundaries should be maintained between doctors and their patients.

This page was correct at publication on 21/12/2010. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.