The power of text

This is a somewhat unusual title for a designer…after all, words are my second language (badly drawn pictures are my first), but since the launch of our ‘talk to us by text’ service, I have a new found respect for words and a seminal bit of technology that is now over 20 years old.

I’m of course referring to text messaging (SMS) – a rather antiquated technology for 2015, but one which is truly ubiquitous and accessible to all (well, most…over 92% of UK adults have access to a mobile phone).

On the 3rd of December 1992, at the ripe old age of 22, Neil Papworth sent the world’s first text message; "Merry Christmas" (timely!) was successfully sent to his colleague Richard Jarvis at Vodafone. I wonder if he foresaw text messages being used as a mainstream form of communication for people to access NHS sexual health services?

Text messaging is currently an integral part of SH:24 – it’s the preferred option for users to communicate with us and for us to communicate with them. We not only use text messaging to inform people of their test results, but also to keep them updated as to the status of  their order, from dispatch to lab receipt and to refer and signpost them to other services.

What I hadn’t fully foreseen when we started to play with text messaging, is that as soon as we text a user, we immediately open a two-way-dialogue with them, which has immense value. So our intuition told us that if we offered support via the medium of text, people would use it…and they certainly have. But why?

5 things I have learnt about why our users prefer talking to us by text


Text messaging is easy – you receive one, type a few words and hit reply. No matter how entry-level the handset, it’s available on every phone. It does not rely on mobile data or having a third party app installed. But above all, it’s convenient (you can send while sitting on a bus, on a loo break, or standing at a bar), plus it’s cheap.


It’s amazing how frank and honest our users are via text – having talked to my clinical colleagues, there’s evidence to suggest people are much more likely to reveal and discuss intimate symptoms and feelings remotely than in face-to-face consultations. This means that, although text conversations are inherently less personal (because you’re not talking to another human being face to face), they can become, paradoxically, more personal as users reveal more, quicker.


People trust our messages, not only what’s in them but how they are sent. This trust, I think, is driven by three things: people’s familiarity with texting, the user experience that we have designed around them (the service), and that we are affiliated with the NHS.  


They’re instant. If someone receives a text message from us, they typically reply within 10-15 minutes. Recent research suggests that people read text messages within 3 minutes of receiving them – this allows us to harness that rich dialogue, encouraging trust.  


We receive at least ten text messages a week from users telling us, completely unsolicited, their experience of the service – so it's an easy way for people to tell us what they think of us and a rich and constant source of insights that enable us to improve the service.  

Yet another top 5 - what are our users talking to us about?

I have symptoms – help!

Unprotected sex – help!

Genital health – are my private parts healthy, do you also test for XYZ?

Pregnancy test – can you send one?

Emergency contraception – what sort and where can I find it?

So… despite the rapid growth of alternatives such as WhatsApp, reliable old text messaging still remains our preferred way of talking to our users (for now)… we’ll see how Web Chat fares in January!