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A short message system (SMS) platform that allows customised conversations between the ‘host organisation’ and the individual so that the impact of the programme/service can be measured quickly and efficiently. The communication platform will be used to measure the impact of the self-management programmes/services within Wales. The communication system has been developed in Wales, by Nudjed Ltd, as a tool to improve health outcomes through better patient communications. The SMS service provides better and more consistent engagement with individuals, and groups of patients. It also helps improve service outcomes through the analysis of quantitative data.

Evidence suggests that outcomes assessed and reported with SMS on mobile phones or with questionnaires completed with pen and paper provide comparable scores. However, the SMS method provided high response rates (> 97%) in a multicentre setting (Christie et al., 2014).

A small scale pilot has taken place in North Wales, where the Education Programmes for Patients (EPP) Cancer: Thriving and Surviving (CTS) course participants were asked a number of questions via the SMS service about the CTS course and its impact on their lives. The participants were asked questions at week 1, of the 6-week course (i.e. when they start the course), and the same questions after 3 months. The pilot of this approach has demonstrated very encouraging results about the impact of the CTS self-management programme and how effective the SMS platform is for harnessing customised patient communication, to deliver better self-management outcomes.

An SMS conversation platform provides a great opportunity to better demonstrate the outcomes and impact of self-management programmes/services, by:

  • Better utilising customised patient communication
  • Partnering with patients in a more efficient, effective, and timely manner to gain invaluable feedback on self-management programmes/services
  • Better and more consistent engagement with individuals and groups of patients
  • Helping improve patient and service outcomes through the analysis of quantitative data in a proactive manner

How you can contribute

  • Questions about the idea to help clarify the early findings and how the idea could be progressed
  • Any useful evidence around this type of SMS approach
  • Advice on how to progress and scale-up the idea form its original pilot


  1. Hi Hawys

    Thank you for your interest in this idea and your comment. In response to your questions I can provide the following information. Patients will provide the feedback on self-management courses via the SMS system. The evaluation of this feedback will be done by the Self-Management teams within Health Boards, who manage the local coordination and delivery of the self-management support. The Health Board Self-Management teams will work with the Person Centred Care team, within 1000 Lives Improvement, to development self-management courses and support based on this feedback. Customised conversations in terms of Health Boards and 1000 Lives Improvement been able to develop and tweak questions we ask patients through the SMS platform should that be appropriate. Any customisation of questions/communications will be done in a collaborative manner, and to benefit the self-management support. There will be a standardized list of questions, however, we have the ability with the system to change the questions to be more disease specific i.e. questions aligned to cancer for those patients who attend the EPP Cancer course, or diabetes specific for those patients that attend the diabetes self-management course. I hope this helps.



  2. Hi Wayne. I’m quite astounded by the 97% response rate to the SMS method! I’m not entirely certain I understand what you’re proposing here, so excuse the, perhaps, slightly obvious questions. You mention the SMS platform will be used to evaluate self-management programmes / services in Wales, but who exactly will be doing this (hospitals, GPs, third sector etc) and how will they access it? You also mentioned that it will allow customised conversations – could you clarify what you mean here? For example, is there a standardised long-list of evaluation questions, which the host organisation can select from to customise the SMS’ for their particular service / programme? Or do they need to write their own questions and upload them onto the platform? Thanks.

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