Text message communication in general practice

Text messages are a low-cost and low-effort way for GPs to keep patients updated, particularly for large-scale communications such as flu jab reminders.

Patients may prefer to be contacted in this way, and they may be more likely to read a text message than an email - and less likely to miss their appointment with a text reminder.

However, when communicating with patients via text message, bear in mind that a simple oversight could risk breaching confidentiality or data protection law.

What constitutes text messaging?

  • 'Text messaging' covers a variety of systems and apps, including SMS, WhatsApp, Facebook Messenger and related formats.
  • All of these are covered by the Data Protection Act and overseen by the Information Commissioner.

GMC advice

The GMC recognises that text messaging is convenient and can be effective, but warns doctors to take reasonable steps to make sure whichever communication they use is secure.

Patient permissions

  • Make sure patients have opted in to being contacted by text message. Providing the practice with a mobile phone number is not deemed consent for this purpose; a patient will have had to actively agree to receive texts, with this clearly marked in their records.
  • Let the patient know what kind of information they can expect to receive (eg appointment confirmations, repeat prescription reminders) as you can only send them texts on these or related matters.
  • If communicating investigation results or other clinical matters by text, specific consent needs to be sought for each instance. In most cases it will be better to communicate this information face to face or with a phone call.
  • Patients should be able to opt out of the arrangement at any time.

Confidentiality concerns

  • Keep in mind the potential pitfalls of communicating via text message - for example, a family member accessing the patient's unlocked mobile phone, or the phone being passed on, sold or stolen and ending up in the possession of someone else.
  • Stress the importance of the patient keeping you updated of any changes to their contact details.
  • Some patients may have their phone linked to other devices, such as their tablets. When structuring your text message, keep in mind that it could pop up as a notification on another device.

Children

  • A Gillick-competent child may wish to have some aspects of their care managed confidentially, but might want their parents to be involved in certain communications about their health.
  • Take care to update the contact details of all competent young patients so that their parent/guardian doesn't receive confidential information, if parental contact numbers are also stored in the child's records.

Professionalism

  • Text messages are considered professional communications and should be noted on the patient's record, as well as any responses received and the time and date.
  • Use similar terms to those you would use in emails or letters. Avoid abbreviations or 'text speak'.
  • It's useful to have a system in place for reviewing and approving standard messages. If you're unsure whether a more complicated message may cause a misunderstanding, run it by a colleague before you send it.
  • Use an established text message service for your communications, rather than a personal phone.
  • Make clear to patients that text is not a channel for clinical enquiries or conversations.
  • It's a good idea to have a practice policy on the use of text messages posted in a prominent place within the practice, such as the waiting room, and given to patients as a leaflet when they provide their mobile number.

This guidance was correct at publication 01/08/2019. It 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.

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