Reminder service generates £1.4 million of savings and reallocation of 10,666 appointments in 1 year


In 2013, 50,000 outpatient appointments were missed at the Health Board. At £150 per slot, this is at significant cost and greatly impacts on delivery of an efficient service. Delays in patient care also increase without reutilisation opportunities.

We chose Healthcare Communications because of the strength of their bid, and the service offering, which covered texting, IVM and agent calls. We were impressed with their commitment to deliver a bilingual approach, which was essential in North Wales.Richard Walker – Informatics Lead.

To overcome the issue and improve access to services, Betsi Cadwaladr decided to implement new communication technology to remind patients of upcoming appointments.

Blend of communication channels

In April 2014, the Healthcare Communications team worked with the Health Board to develop sophisticated scripts in both languages across channels. Patients could also interact with the technology and respond with confirm, cancel or rearrange their appointment.

The first phase of the project introduced patient reminders via SMS and Interactive Voice Message (IVM) with the option to receive the message in either Welsh or English. Envoy Messenger software then reports on outcomes, meaning cancelled slots can be reused to reduce waiting times and increase income.

Phase 2. Agent call implementation

In December 2014 Agent calls were added to the communications portfolio with the following objectives:

  • Improve patients access to care by increasing slot utilisation using every means possible
  • A totally bilingual Agent call reminder service to follow up when other communication connections cannot be completed
  • Contact hard to reach patient groups and when land line only details are provided

40,000 patients are now reminded monthly, up to 10% of these are delivered by agent calls. This is especially relevant when SMS or IVM’s are not completed; an agent call will automatically follow to ensure every channel is used to reach the patient.


  • Successful implementation of our bilingual agent call facility to cater for the English and Welsh speaking population
  • Up to 6,000 patients now confirm their intentions through agent calls. In 2015-16 10,666 slots were made available for reallocation resulting in £1.4 million of savings
  • Enhanced patient Experience! In September 2014, a patient evaluation was undertaken on the reminder service. 88% of patients rated it ‘great’, 8% ‘good’ with the remaining 4% commenting on other elements of the healthcare
  • A reductions in DNA rates across all departments

Award winners

Besti Cadwaladr and Healthcare Communications commitment to providing a totally bilingual reminder service has also received recognition! In the Welsh Language in Health Social Services and Care Awards, the Health Board was shortlisted in the IT and the Welsh Language category 2014 and winners in the recent 2015 awards!


Betsi Cadwaladr sent nearly 410,000 7 day reminders in 2015-2016 of which 6000 were delivered by bilingual agents calls. 467,000 24 hour (one way) reminders were also sent in this time to improve on reutilisation opportunities. The Health Board’s dedication to financial efficiency resulted in a 2015 local press story on results achieved.