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Practices should get patients’ consent to text, advises defence union

15 March 2010

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GP practices that communicate with patients via text message are being advised to ensure patients have “opted in” to the service.

Increasingly practices are looking at text messages as another way of communicating with patients. Uses include reminding patients about appointments, or to take medication, communicating test results, or checking on a patient’s progress.

But the Medical Defence Union (MDU) says it is unwise to rely on patients’ implied consent to allow the practice to communicate with them in this way. It is better to adopt a cautious approach and get the patient’s express consent, the MDU advises.

Dr James Armstrong, MDU medicolegal adviser, said:
“While GPs may publicise a text message service to patients on the practice website, practice leaflet and through posters in the waiting room, many patients may still not be aware of the service.

“They might be surprised to receive a text message from the surgery if they had not given their specific consent and this could lead to a complaint, particularly if the unexpected message is somehow picked up by somebody else.

“For this reason, it’s probably better to err on the side of caution and ensure patients give specific consent to be communicated with by text, so their confidential information can be protected, in line with General Medical Council (GMC) guidance.

“That way, the GP also has an opportunity to reassure the patient about the security arrangements in place and to ensure they have the correct mobile number to avoid the danger of confidentiality breaches.”

The MDU issued the following advice to practices wishing to communicate with patients by text message:

  • Ensure the benefits of any system outweigh the risks – take all reasonable steps to ensure patient confidentiality is protected.
  • Ensure all those involved in the use of the system, including patients, fully understand what information will be transmitted.
  • Consider extra security measures if you plan to communicate sensitive information, such as test results. For example, by asking the patient to respond to a message confirming their identity by using a pre-arranged password immediately prior to transmission. Alternatively, consider using a different method for communicating such information.
  • Document details of text messages sent to or received from patients in the medical record. Include the date and time of transmission, the content of any message and the details of any reply.
  • Consider alternative or additional methods of communicating important information to patients, such as requests for urgent follow-up.


See related MiP article: Textual healing: SMS patient messaging systems in surgeries