An integrated care board (ICB) has delayed implementing a cost-cutting measure to limit funding for text messages following pressure from GP practices.
North East and North Cumbria ICB is introducing a cap on SMS funding which will mean that practices that exceed that limit will have to pay for the extra messages to patients themselves.
GP practices have opposed the measure and told Healthcare Leader’s sister title Pulse that this would mean a ‘direct transfer of cost onto practices for core operational activity’, costing them thousands of pounds each year.
The measure was planned to be in place from the beginning of April, but has now been delayed to 1 July following pressure from local practices.
The ICB will introduce a ‘fair share’ funding allocation for SMS messaging used by GP practices, investing about £1 million.
Practices will receive an allocation for SMS and will have to pay for messages ‘where they exceed their allocation’, the ICB said.
It added that this was a response to overall SMS spend ‘exceeding £1.7 million per year’, while ensuring ‘ongoing, sustainable support for this critical digital communication’.
One practice told Pulse that the measure could cost them more than £6,200 a year if current usage is maintained.
One practice manager said: ‘It is a direct transfer of cost onto practices for core operational activity – using tools that the ICB has encouraged practices to utilise, and continues to fund, such as AccuRx & eConsult.
‘At our practice, consistent use of SMS reminders has reduced our DNA rate from 6.5% to under 3%, protecting clinical capacity equivalent to approximately £17,000 per year.
‘Faced with a £6,000 cost pressure, practices will inevitably reduce SMS usage, including appointment reminders, with a predictable consequence: DNA rates will rise again and clinical capacity will be lost.
‘SMS also replaces a significant volume of administrative work. At our practice, this equates to around 250 staff hours per month that might otherwise be spent on telephone contact — over £3,000 per month, or £38,000 per year in staff time alone.’
The ICB told Pulse that after taking on board feedback from practices and LMCs the implementation of the new approach will be pushed back to 1 July.
NHS England has said that the NHS App should become the ‘default option’ for GP practices to contact patients starting from this financial year.
A spokesperson for the ICB said: ‘It is vitally important that GP practices provide clear communication to patients and this can be through a number of different ways.
‘This could be via a telephone conversation, email or text message, through the practice website or social media or via the NHS App, which is becoming the go-to form of communication where patients can book appointments, access test results and order repeat prescriptions on their tablet or smartphone.
‘As the capabilities of the NHS App increase, it is important that the NHS moves towards establishing the App as the go-to method for communicating with patients and starts to move away from costly alternatives such as SMS text messages.
‘For some time now, we have been working with our practices on the appropriate use of SMS messaging.
‘Every practice has received monthly usage data and access to further support such as webinars and guidance on how to keep messages concise, clear and factual to not only improve the clarity of messaging with patients but also to reduce unnecessary SMS costs.
‘Since then, the number of practices spending more than £60 per 1,000 patients per month has reduced by 51%, while the number of patients downloading the NHS App has increased, though we are still below the national average and have work to do to increase that number.’
A version of this story first appeared in Healthcare Leader’s sister title Pulse.
