Using email and text message for communicating with patients.
Guidance from the Information Governance team at NHS GM – Manchester locality
Organisations are increasingly using digital methods, e.g. email and text messages, to communicate with patients. We are supportive of text and emails being used where they can support the delivery of care.
General principles
It is essential that use of information is in line with fair processing guidance and best practice. Fair processing is an element of the Data Protection Act 1918 (DPA) which makes clear that the use of personal data and information by an organisation must be understood by that patient.
In all instances, a patient should be able to change their preferences at any time and without having to give a reason. Requests to change contact or communication preferences must be actioned accurately and in a timely manner (where possible, immediately).
Guidance
- Take reasonable steps to make sure the communication methods used are secure and ensure they are meeting their transparency responsibilities by providing information about how they use the email addresses and mobile telephone numbers.
- Consider how to inform patients that text messaging/email is available e.g. website, notice board, poster.
- Be transparent with patients about how information is being used.
- It is appropriate to rely on implied consent for confidentiality purposes when contacting individual patients about their individual care or requesting they complete a friends and family test survey.
- Respect patients’ objections/preferences to receiving communications in this way
- Have processes in place to remind patients to update their email address and mobile number when needed. Explain to the patient that it is their responsibility to keep and provide an up-to-date email address and/or mobile phone number, and to be clear that the service is not responsible for onwards use or transmission of email or text message once it has been received by the patient.
- Services, and their staff, should only send emails from generic team accounts and established corporate text messaging accounts. This ensures that patients can be confident that the sender is legitimate. Individual staff email addresses should not be used. Patients should only send emails to practices generic email accounts. Use of generic accounts ensures that emails and text messages can be accessed and actioned by multiple members of staff, providing cover in the event of absence.
- It is best practice to acknowledge receipt of an email within 24 hours.
Transparency information
It is important to be clear and upfront with patients about the scope and purpose of the service being offered, how their personal data will be used and accessed and individual rights. Information should be made available explaining to the patient how their information will be used and what information will be texted/emailed (e.g. appointment reminders). It should also be clear that text messages and emails will not be read during non-working hours and therefore should not be used for urgent queries.
Practices should make this information readily available to their patients:
- During the registration process
- When a mobile phone or email address is recorded/updated
- Through online applications, e.g. Patient Online
- During contacts with the patient, either in person or on the phone. This doesn’t need to be with the Clinician and could be with reception staff.
- Through information in a waiting area which highlights the benefits to patients
Patient preferences
It is important that any preferences are recorded in their record and respected. Patients should be able to change their preferences about how they are contacted at any time. For children and adults lacking in capacity, someone with parental responsibility or who has power of attorney for that person can make this preference on their behalf.
Children
The age at which a child becomes competent to make certain decisions about their health and care and information sharing will vary depending on the child and the particular decision.
A child with competency and understanding is able to make choices about how health and care providers use their information. As such they should be able to make preferences about who receives emails and messages about their care.
Confidentiality
It is important to consider the possibility that someone else may read a text message or email that you send to a patient, e.g. a family member accessing their unlocked mobile phone, or the phone being passed on, sold or stolen and ending up in the possession of someone else. With this in mind, consider what information it is appropriate to include and whether clinical information, e.g. test results, should be shared via a portal requiring user verification, such as Patient Online or the NHS App. Only the minimum amount of personal data for the purpose should be communicated via email/text.
Recording information
Emails and text messages in the health and care setting are a professional communication. Any message together with any response received with the time and dates should be noted on the patient record.