SMS Wait Time Notifications for NHS Appointments
NHS England / Behavioural Insights Team · England, United Kingdom · 2012
Summary
The NHS/BIT experiment demonstrated that a simple personalized SMS reminder reduced appointment non-attendance by 26%. The mechanism combines memory activation (most missed appointments are forgotten rather than deliberately avoided) and action facilitation (the SMS includes a cancellation option, allowing patients who cannot attend to free the slot). The cost-benefit ratio was exceptional: £0.10 per SMS against £30 in recovered appointment value. The intervention has been replicated in over 20 countries and is now standard practice in most NHS trusts. It is among the highest-ROI behavioral interventions documented in health administration.
Research question
"Does sending SMS reminders for outpatient appointments reduce did-not-attend rates?"
Methodology
Intervention
Patients sent SMS reminder 72 hours before appointment including option to cancel; personalized with patient name and appointment details
Assignment
Randomized controlled trial (appointment)
Sample size
26,000 appointments
Primary outcome
Did-not-attend (DNA) rate
Effect estimate
DNA rate fell from 11.4% to 8.4% (26% reduction); £30 saved per appointment avoided
Decision
SMS reminders adopted across NHS; now standard practice in UK and dozens of other health systems
Result
Positive
DNA rate fell from 11.4% to 8.4% (26% reduction); £30 saved per appointment avoided
Evidence strength
Strong
Randomized trial, replicated across multiple sites or studies.
Replication status
Replicated
Institution
NHS England / Behavioural Insights Team
Location
England, United Kingdom
Year
2012
Policy area
Administrative Process
Mechanism
Information