The challenge
This case study examines how Houghton Medical Group inadvertently increased NHS App utilisation among patients via their directly bookable online appointment process, particularly for the Flu Vaccination clinics.
Taking into consideration the cost benefit of patients enabling and utilising the NHS App messaging
and notification service, and the benefits to both practice and the patient.
Houghton Medical Group made the decision to begin issuing directly bookable appointments that did not require triage, due to the COVID-19 pandemic, as means to reduce the impact on the practice phone lines, which were experiencing increased demand as a consequence of the national social distance restrictions.
Our response
The practice issued Flu and COVID-19 vaccination clinics via SMS as they were easy to manage, required one clinic, one nurse and easy to identify a cohort of patients eligible for an invite to an appointment. The practice determined eligible patients by running a report within Ardens, their clinical decision support tool, searching for patients 65 over and 16-64 at risk.
The practice currently utilises AccurX to manage how they issue SMS messages to their patient population. Accurx has an appointment management functionality known as Accubook, allowing the practice to issue a schedule of appointments directly to a cohort of patients via SMS. This functionality links the patients to the online Accubook service to pick a date and time from the schedule of appointments issued, allowing them to book their appointment directly without needed to contact the practice through traditional methods.
If enabled, Accubook integrates with the NHS App, whereby any batch appointment booking messages and reminders that are made via Accubook, will default to the patients NHS App messaging and notification service, should the patient have it enabled, falling back to an SMS fragment after 24 hours. The NHS App messaging and notification service has been made available by NHS England to all NHS commissioned services for free, further information can be found; Notifications and messaging in the NHS App – NHS England Digital
Outcomes
Upon review, the Deputy Practice Manager – Sophie Griffiths, noted the Accubook system reported that approximately 52% of their patients did not have the NHS App installed, 21% had the App installed with the notifications disable, and 27% had the App installed with the notifications enabled.
From June to November 2024, the practice has seen a decrease in patients without the NHS App, and an increase of patients with the notifications enabled and a decrease in patients with notifications disabled.
The practice has saved 5K+ SMS fragments for appointment reminders and 2K+ SMS fragments for appointment self-book links, when issuing batch messages via the NHS App.
The practice could be even more successful by saving an additional 12,245 fragments, if the patients who have the App, enabled their notifications to allow them to read the message within the pre-fallback timeframe.
Sophie noted the practices benefits testimonial for the digital solutions and process:
- Using self-book texts saves significant time, especially during flu season, by allowing batch messages to 1,000+ patients to self-book or decline vaccines, with responses coded into the record. This frees admin staff to focus on contacting patients without mobile numbers and reduces call volume, easing pressure on phone lines and reception staff.
- Self-book also helps manage clinic capacity and prevents booking errors by restricting slots to specific patient groups. Staff report reduced stress due to fewer calls and less manual booking work.
- Initially used for vaccines, the practice now supports other patient care areas, such as smear tests, offering patients flexibility to book appointments that suit their schedules. The practice has future plans to expand self-book for chronic disease management and are training more staff to use it for conditions like diabetes, asthma, and heart disease.
“I recently booked my Flu Vaccine appointment through the NHS App, and it was incredibly easy and convenient! I received a notification inviting me to the practice Flu clinic, booked my slot in minutes, and even got updates leading up to my appointment. It saved me time and the hassle of calling the practice. I’ll definitely be using it for future appointments!”