Messages: reading and replying to patient texts

The Messages page is where you read the texts your patients send you and reply to them. It works like the messages app on your phone, except it is shared by your whole team and conversations link to a patient's record when the number is matched to one.

What you see on the page

On the left is a list of conversations, one per patient who has texted you, with the most recent at the top. Each one shows the patient's name, the last message and when it was sent. If the last message came from your clinic, it starts with "You:". Patients who have only ever received texts from you are not listed here; to see what was sent to them, use their patient record (see below).

A number in a coloured circle means that patient has texted you and nobody has read it yet. The badge beside Messages in the menu shows the total unread texts for your clinic, so you can tell at a glance when patients are waiting for an answer.

Click a conversation to open it. Your clinic's messages sit on the right in colour and the patient's sit on the left in grey. The conversation also shows the automatic messages the system sent that patient, such as appointment reminders, so you can see exactly what they were replying to. A small icon under each message tells you whether it was a text or an email.

Opening a conversation marks it as read for everyone on your team, so two people do not both answer the same patient.

Replying to a patient

1. Open the patient's conversation.
2. Type your message in the box at the bottom.
3. Click Send SMS.

A successful send appears in the conversation straight away. It normally uses the shared replyable number. If another clinic owns replies from that mobile, your text includes your clinic's contact instructions and cannot be answered through your Messages inbox. For a UK mobile, it uses a named sender; if suitable contact details or a valid sender name are unavailable, it is skipped. Each reply uses SMS credits, just like an automatic text. The number of credits you have left is shown under the reply box, and if you run out you will be asked to top up before the message sends.

The replyable phone number is shared across clinics. Replies to the shared number belong to the first still-open clinic that successfully sent that mobile a text from the shared number. A named-sender text does not establish ownership of replies to the shared number. Other clinics may send named texts with their own contact instructions, and patients cannot reply to those.

When you cannot reply

Sometimes the reply box is replaced by a short note explaining why. The usual reasons are:

• The patient is not opted in to texts. Replies can only go to a patient whose Marketing SMS box is ticked on their record. An unticked box with no recorded consent is different from a withdrawal: Opted out means consent was withdrawn. Texting STOP withdraws SMS consent at every clinic that has texted that number from the shared number. This stops anyone on your team texting a patient who has asked you not to. No text message from the patient can tick it again: if they tell you they want texts, tick Marketing SMS on their record, and if they had texted STOP they also need to text START so their mobile network lets texts through again.
• There is no mobile number on the patient's record. Add one to their record and you can reply.
• The number is not linked to a patient. The conversation shows a phone number instead of a name. Add that mobile number to the right patient's record (or create a new record for them) and you can reply.

Did my message get through?

Under each text you send, a short note appears if anything needs your attention:

• Sending… The text is on its way. This normally clears within a few seconds.
• Not delivered. The text did not reach the patient's phone. Check the mobile number on their record, or call them.
• Blocked by SMS filtering. The patient's mobile network stopped the text, usually because of something in the wording, such as a link. Try rewording it, or call the patient.

No warning does not prove delivery. Sent means the provider accepted the message; Delivered means a delivery update confirmed it reached the destination.

Some automatic texts are sent under your clinic's name instead of a phone number. Patients cannot reply to those, and the conversation says so under the message.

Checking everything sent to one patient

The Messages card on a patient's record shows their ten most recent logged messages; Most recent 200 opens a conversation containing up to 200 messages. Each message shows what it was (for example "Reminder 24h"), whether it was a text or an email, and what happened to it:

• Sent. Handed over for delivery.
• Delivered. Confirmed as reaching the patient's inbox or phone.
• Failed, undelivered or bounced. It did not get through. Check the email address or mobile number on the record.
• Suppressed. The patient's automated-message preferences prevented the send.
• Skipped. The system chose not to send it on purpose. The usual reasons are: no email address on file, the clinic had run out of SMS credits, that message is switched off in your settings, or the phone number had already had its share of texts (see below).

To protect your SMS credits, one phone number can only receive so many automatic texts: eight appointment reminder texts a day across all their bookings, three waitlist offer texts an hour (six a day), and three texts an hour (six a day) about appointments the patient moves themselves. When a number reaches its limit, an independently enabled email can still go and the text shows as skipped. No credit is used for a text that was not sent. Appointments your team moves are never limited.

An email address that bounces is automatically left out of future marketing, so you do not keep sending to an inbox that no longer exists. Click Most recent 200 on the card to open that patient's conversation on the Messages page.

Good to know

• When a patient texts in, a generic new-message notice is emailed to your configured clinic contact, or to your current active owners if no clinic contact is available. The email contains no patient message content. Open Messages to read and reply; replying to the notice email does not reply to the patient. This includes opt-out replies such as STOP, CANCEL or END: the text appears in the conversation with a note that marketing texts were withdrawn (see What happens when a patient texts STOP).
• Use the search box at the top of the list to find a conversation by patient name or phone number.
• Replies are sent by text only. The Messages page does not send emails.

The conversation reply box sends SMS. To send a care email, open the patient's Messages card and choose Send an email. See Sending a one-off patient email.