Case Study: Theatre Utilisation increases to 87% with appointment reminders


In 2010, Healthcare Communications worked with Portsmouth Hospital Outpatient clinics to implement a SMS patient appointment reminder service. As a result, clinic utilisation increased to 92% and Did Not Attends (DNA’s) reduced by 38%.

However, letters are still the primary communication method for patient’s surgery appointment reminders. Once a patient is placed on the 18 week (RTT pathway) there is often no contact from the decision to treat the patient to the point of surgery. During this period a patient’s personal circumstances can change, symptoms worsen or in some cases resolve. More accessible lines of communications would greatly benefit patients and prevent costly DNA’s.


With the introduction of national 18 week waiting list targets in 2014, pressure has increased on Trusts to maximise theatre utilisation. External auditors pinpointed 34% of ‘on the day’ DNA’s could have been identified before the surgery day.With this knowledge, the Theatre Productivity Project team decided to pilot SMS Appointment Reminders one week prior to surgery. The 3 Clinical Service Centres (CSC) with the highest DNA results were invited to take part.


  • Reduce DNA’s and increase theatre utilisation by implementing new communication technologies to remind patients of surgery appointments.
  • Open up accessible lines of communication between the hospital and patient.
  • Improve internal communication processes to enhance patient experience.

As a proven supplier that has significantly reduce DNA’s in Outpatient clinics, the Trust chose to work with Healthcare Communications for the trial. Envoy Messenger Appointment Manager was implemented to collate data and report on responses received.


  • Theatre session utilisation increased to 87%.Waiting list managers are now given the opportunity to remove patients from the operating list in sufficient time to be replaced.
  • DNA’s reduced in each CSC taking part.
  • Patients could easily inform the hospital if unwell by SMS, meaning a pre-operative assessment nurse could contact them for further assessment.
  • New streamlined communication processes between waiting list staff and operating theatres greatly improved internal efficiency.
  • Created an opportunity for patients to make contact the hospital with other requests such as ‘Can I please have transport arranged?’ opening up a new channel for patient communication.

Phase 2

Due to pilot success, Trust wide roll out of SMS reminders to all Clinical Service Centres commenced in April 2015. Where only landline numbers are available or SMS fails, Interactive Voice Message (IVM) has also been added so that all patients can benefit from a reminder.

Gillian Ryan, Project Manager for Theatre productivity adds:

‘Healthcare Communications provide automated communications for Portsmouth NHS Trust, hence were the chosen provider for the trial, with a proven record of reducing DNA’s by up to 64%’