Flo is a text messaging system that sends patients reminders and health tips tailored to their individual needs. As our Flo: telehealth with a human touch film shows, Flo has had a huge impact on people’s lives, revolutionising the way patients manage their own health. Since 2010 it has been used by more than 30,000 people in over 70 health and social care organisations in the UK. Here we explain how Flo works and why it was developed.

What is Flo?

The Florence Simple Telehealth text messaging system, or ‘Flo’ for short, was named after Florence Nightingale, the founder of modern nursing. It is a text messaging system with a human touch, and has helped to transform the lives of thousands of patients since it was first introduced by a team at NHS Stoke on Trent in 2010.

A young man reads a text message from Flo

How does Flo work?

The technology behind Flo is fairly straightforward. Clinicians (doctors or other health professionals such as nurses or community matrons) can adjust the settings on Flo for each patient, defining when messages should be sent, what information they are asking for and how the system should respond. Flo then sends regular text messages to patients helping them to monitor their health, sharing any information sent back by the patient with the person managing their care.

For example, a patient with hypertension could be asked to check their own blood pressure each morning and then to text the results back to Flo. If the results are outside agreed limits, Flo will pass this information on to their clinician, while also suggesting that the patient makes an appointment or speak to someone on the phone.

It enables much more detailed and regular monitoring of a person’s health condition than is possible if a patient just attends regular appointments. Clinicians are also able to view real time information about their patients at any time via a simple web interface.

Developing Flo

The system was developed by a team at NHS Stoke on Trent (now Stoke Clinical Commissioning Group) to encourage patients to stick to their treatment plans, particularly for long-term conditions such as diabetes or hypertension. The team worked closely with telecommunications partner Mediaburst Ltd to develop a simple system.

An early clinical trial showed the impact using Flo had for patients with hypertension and chronic kidney disease. The trial showed better and faster clinical results in managing people’s blood pressure compared to a group of patients who didn’t use Flo. The patients who used Flo also had high levels of patient satisfaction. Results went on to be published in the BMJ and interest in Flo has grown ever since.

Rolling out Flo

Encouraging more areas of the NHS to use the Flo system is now the responsibility of nhssimple, a social enterprise. nhssimple supports health professionals to use Flo and is helping to build a community of people working in health and social care who can share knowledge and learning about the many different ways Flo can be used.

nhssimple and NHS Stoke-on-Trent CCG have now rolled Flo out to more than 70 health and social care organisations across the UK. It is being used to support an ever growing list of conditions, including asthma, heart failure, chronic obstructive pulmonary disease (COPD), and stress incontinence. It’s also being used to make sure patients take their medicines, to aid recovery after surgery, and to support people who want to stop smoking or lose weight.

An adapted version of Flo, named Annie, is also now being used to support veterans in the US.

Flo received funding from The Health Foundation in 2011.

More about Flo

Article

Overview of the Florence Simple Telehealth text messaging system

Article

Since 2010 Flo has been used by more than 30,000 people in over 70 health and social care...

Article

How Flo came to life

Article

From a vision for how simple technology could be used to change patient behaviour, to the Simple...

Article

How Flo is making a difference

Article

We spoke to Sian Clark from Nottinghamshire and Rachael Forbister from Sunderland about the many...

Article

From Flo to Annie

Article

Annie is a mobile messaging system based on Flo. It’s now being used as part of the health care...

You might also like...

Event

Webinar: Tech and NHS recovery – what you should know

Event

Friday 25 June, 9.45–11.00. How can technological innovation help speed the recovery of the NHS and...

News

Four innovation hubs to be established as part of the Health Foundation’s programme to improve the adoption of health care improvements

News

Four areas have been selected to be part of a new programme supporting health care providers to...

Press release

To realise potential of health data, government must ensure transparency and build trust

Press release

Health Foundation response to the publication of NHSX's data strategy

Kjell-bubble-diagramArtboard 101 copy

Get social

NHS Test and Trace celebrated its first birthday last month. We've tracked its up and downs and reported on its su… https://t.co/Iro6fcRdgH

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more