Automated SMS patient appointment reminder functionality

An article in The Times in 2011 stated that, “Almost seven million patients failed to keep hospital appointments last year, costing the NHS hundreds of millions of pounds in wasted time and lost revenue’. It goes on to say that “The Government has estimated that a missed appointment costs more than £100 in lost hospital revenue and time wasted. This would equate to almost £700 million over the 12 month period”.

The NHSmail SMS service allows NHS organisations to utilise free at the point of use SMS messaging to contact patients and remind them of an upcoming appointment, helping reduce hospital / GP practice did not attend (DNA) rates. An example of how one GP practice has used NHSmail to reduce DNAs is outlined below:

• The practice has seen a 50% reduction in patient DNAs. At £31 per GP appointment (11.7 minutes) this equates to £158.97 per hour

• The practice has realised a benefit of eight hours a month of GP appointments not missed. This equates to £1,271.76 non-cash releasing benefit per month (£15,261.12 per year)
• The SMS service is also used to proactively advise patients to contact the practice when vaccinations such as the seasonal flu jab are available.

For a breakdown of savings that a number of different organisations are realising by using the NHSmail SMS feature as part of established workflows, please download the following document. 

It details how a Foundation Trust, Scottish Health Board and GP Practice are using NHSmail and the cash releasing and non-cash releasing benefits that they have realised.

Examples of SMS cost savings (PDF, 261.9kB)

Automation of the discharge summary process

In April 2010 a new national standard was included in the NHS contract: Acute Hospitals are now required to send a discharge summary to a patient’s GP within 24 hours of the patient’s discharge. If the discharge summary is late a penalty is incurred. Below is an example of the benefits one NHS Trust estimates that NHSmail is helping them realise by sending discharge summary notifications via secure email :

• The Trust estimated that using the previous non-automated process, 40% of discharge summaries arrived late  which would equate to £32,000 a year and £160,000 over five years in penalty charges under the new regulations
• The introduction of sending discharge summaries via NHSmail allowed a reduction of staff within the Discharge Summary Team (band 4 bank staff). This equated to an estimated saving of approximately £30,000 annually, £150,000 over five years
• Annual savings achieved as a result of reducing envelope, paper, postage, print and labour (resource) costs  by using NHSmail was £137,601.

Decommissioning of local Mail Transfer Agents (mail servers or MTAs) and migration to the NHSmail service

When a Trust migrates to NHSmail they no longer need to fund local mail transfer agents (MTAs) which should be decommissioned. Local savings made are released and can be reassigned elsewhere in the Trust. This also means that double spend, as a result of Trusts paying for a local email service when a centrally funded secure email service is available, is avoided.

Trusts migrating to NHSmail can expect benefits in the following areas:

• No future email upgrade costs
• No Exchange engineers required to maintain service
• Reduction in local help desk agents
• Decommissioning of local MTAs (no future maintenance costs)

The estimated saving by one NHS Trust, who migrated to NHSmail in May 2010 instead of undertaking a local migration, was calculated as a one-off cost of £282,900.

Using NHSmail for collaboration across organisation boundaries to improve the patient experience

As well as measurable cost benefits, NHSmail is used extensively across the NHS to improve the patient experience.  Through use of the collaboration element of the service, NHSmail improves the efficiency of geographically dispersed teams by replacing workflows traditionally based on phone and the postal service. The example below shows how Midwifery teams are using NHSmail to help improve the service they offer patients in their care.

• Previously in order to book a woman in for induction of labour, a Midwife in consultation with a patient in a GP practice antenatal clinic had to ring the hospital, wait for the phone to be answered, then wait for them to find the paper diary and a suitable date before the appointment could be booked. This process was proving too lengthy for the patient and taking too much of the midwives’ time
• A secure solution was required that was accessible to the community based maternity staff as well as staff at the hospital
• Using an NHSmail shared calendar, any one of the 70+ midwives can quickly and easily access the calendar via their NHSmail account and book a suitable appointment while the patient is present
• The ward staff use the calendar to print off a daily list of inductions, the Hospital Midwives access it to check who’s scheduled for induction the next day and the Consultants use it to plan elective caesareans sections lists. Any women who deliver early are then cancelled from the bookings leaving space for other appointments and making efficient use of time
• In addition the Midwives use the calendar to make blood test bookings at the hospital clinic whilst the patient is present, cutting out the previous post-based process which took time and often involved rescheduling appointments if they were inconvenient.