Sending text messages reminding people to book their NHS health check following their invitation letter increases attendance, according to a study analysed in NIHR Signal.

NHS health checks are offered to adults aged 40 to 74 years.

Yet only half of adults attend a check when it is offered.

The trial, conducted across general practices in South London, assessed the effect of sending pre- and post-invitation text messages, along with different forms of invitation letter.

Brief time-limited letters, telling people their check was due next month, for example, seemed most effective.

However, any form of letter combined with a reminder text was more effective than no reminder.

Among invited patients, 24% attended health checks.

This ranged from 18% of those sent a standard control letter with neither text pre-notification nor reminder, to 30% of those sent a time-limited letter with both text pre-notification and reminder.

All other approaches significantly increased the likelihood of attending compared with the standard letter and no texts, except a control letter with only the pre-notification text, and a time-limited or social-norms letters without text messages.

A previous Signal reported a similar London-based trial which found sending behavioural questionnaires prior to invitation letters made no difference to health check uptake.

This trial suggests sending text messages reminding people to book can make a difference.

However, about 1,500 people were excluded from the trial because they didn’t have a mobile number.


Sallis A, Sherlock J, Bonus A et al. Pre-notification and reminder SMS text messages with behaviourally informed invitation letters to improve uptake of NHS Health Checks: a factorial randomised controlled trial. BMC Public Health. 2019; 19(1):1162.