Case Studies.

Attenborough Surgery

“I am trialling a bespoke, tailored approach with diabetic patients that wouldn’t be possible without Chain SMS.”

Liz Cross, Advanced Nurse Practitioner at Attenborough Surgery in Hertfordshire, is one of our earliest and most enthusiastic supporters. However, she has also been our firmest critic, absolutely unafraid to tell us what she thinks. It has helped us understand how to improve our products, and develop a service tailored to our users. We are in awe of her energy and drive (example: she recently completed a 100km race for the charity Mind), and it was a pleasure catching up with her to discuss how Chain SMS has benefitted her clinical practice.


As expected, Liz had come up with unexpected ways of using Chain SMS. She has thought about the wider patient journey and experience. “I am trialling a bespoke, tailored approach with diabetic patients that wouldn’t be possible without Chain SMS. I have a large group of well-managed patients. There is a mid-group who need a few tweaks, but then I have a hard-to-reach group who I am targeting, for example sending a text through Chain SMS saying ‘book an appointment with us!’” She went onto explain a specific example: “I have one diabetic patient, medically very complex, who really doesn’t engage and doesn’t answer his phone. I sent him a text through Chain SMS and he phoned me straight back - amazing and unheard of! It only took two seconds out of my day to send the text.”


“I also use it to send information to patients with Learning Disabilities and patients for whom English is not their first language. I can even send the information direct to patients’ carers.”


Engaging hard-to-reach patients appears to be a Chain SMS specialty. Another disengaged patient responded to Chain SMS. They came in for an appointment, had their medication changed, and in the following week Liz sent them a message to check that they were ok on the new drug. “It’s about keeping the ball rolling with these patients. Chain SMS is an integral part of this as I never get the admin time, but I can complete the task in seconds with Chain.”


“I like doing the most I can to help my patients. With Chain SMS I can be proactive. There is a lot of professional pride in doing a job well. I have increased job satisfaction with Chain.”


With a patient list of thousands, it is hard to maintain the personal touch - Liz comments that Chain SMS changes this. “The best thing about Chain SMS is that you have clear lines of communication and direct contact with patients. I like to put a personal touch; I’m always adapting the message to the individual. I can put motivational comments, my own sign off.” On top of that, Liz explains how Chain SMS is helping achieve the holy grail in primary care - continuity of care. She rightly reflects that patients still talk about “my nurse, my doctor - they still want close interaction with their clinicians. Across three sites and a large team of doctors and nurses, Chain SMS helps give continuity of care and the personal touch.”


“I’m sending leaflets about lower back pain with info about red flags and links to YouTube videos for exercises.”


Liz finds that using Chain SMS enriches her clinical practice, even for routine appointments. “For example, during an appointment for a travel vaccine, I can send a link to with an explanation to reinforce what we’ve talked about. The Royal College of Nursing outline minimal competencies for these kinds of appointments. It is easy to meet these quickly with Chain SMS.”


Chain SMS isn’t only helpful for clinical scenarios. Liz told me how Chain SMS had been used to settle a complaint. The patient was questioning the practice’s decision regarding a routine procedure. She wanted the evidence base for the decision. Liz spoke to her, explained carefully and sent through a summary of the discussion, an advice leaflet and links to supporting evidence. “The complaint stopped dead thanks to Chain SMS.”


“Chain SMS takes steps out of the admin process. The message delivered to the patient is accurate and timely.”


“If you needed to contact a patient before, the old process involved multiple missed phone calls. You would then task the receptionists who had a long list of things to do, and eventually they would instigate a letter or a phone call. The message gets diluted. With Chain SMS, you just send a text and everything is saved into the patient notes, so it’s very clear what’s been done.”


Liz, as always, has inspirational ideas for the accuRx team to mull over. She says “Chain SMS is amazing to get hold of patients who are traditionally hard to engage. Take younger patients with mental health issues. You can get through to them, offer proactive help and suicide prevention. If you need to start an SSRI you can ask them to check in with you. With Chain SMS we can stop losing patients into the ether.”


Thanks to Liz for all your feedback and support! It’s great to hear how Chain SMS is being used to holistically improve patient care, and we are inspired by how it facilitates an improved patient journey.