• Project led by NHS Stoke on Trent.
  • Aimed to support patients with chronic kidney disease or hypertension to manage their own condition, to reduce referrals to the renal service and unplanned hospital admissions.
  • Developed an interactive SMS texting service to motivate and support patients to monitor their blood pressure and take appropriate action when needed.

This project is featured in our Power of People series of short films, which offer a unique and moving take on how the lives of people using health services and their families can be improved through the determined efforts of people working in health care.

The NHS Stoke on Trent team used mobile phone SMS texting to support effective management of patients with chronic kidney disease and patients with poor blood pressure control who are at risk of stroke or falls. The aim was to reduce referrals to the renal service and unplanned hospital admissions by:

  • encouraging patient self-management
  • improving the adjustment of anti-hypertensive drugs
  • enabling effective monitoring of blood pressure.

The project team developed an interactive texting system known as Simple Telehealth - or 'Florence' - which requires patients to send specific data, such as blood pressure or heart rate, to a number linked to a secure server. Any data received prompts an automated text response from Florence to confirm that the readings are within range or to recommend steps such as taking corrective action to lower blood pressure or seeking professional advice.

The system allows for interrogation of the data through a secure website, enabling GPs or other practitioners to monitor a patient’s submitted data, even if they have no direct contact.

Who was involved

The project team worked with a mobile marketing and telecommunications company to develop the SMS system.


Outcomes of the project included:

  • more effective management of stage 3 and 4 chronic kidney disease
  • improved blood pressure control
  • improved patient self-management
  • reduction in face-to-face consultations
  • reduction in hospital outpatient referrals and admissions for deterioration of chronic kidney disease from stage 3 to stage 5
  • reductions in hospital admissions from stroke, falls and fractures
  • 96% of patients very satisfied using SMS.

Further reading

Learning report

Shine: Improving the value of local healthcare services

February 2014
Learning report

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