Content guide
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Writing NHS messages
How to write NHS App messages, text messages, emails and letters for patients and the public, with advice on structure, tone and wording so your message is effective and easy to understand.
Who this guidance is for
This guidance is for anyone who writes or edits patient messages, including:
- content designers
- communications teams
- administration staff
If you need guidance on messaging strategy, governance requirements, or using NHS Notify visit the Messaging best practice section of the NHS England website.
Use this guidance if you want to:
- write messages that work well on different channels
- choose wording that patients understand
- make content inclusive and accessible
- find examples and templates to reference when writing your message
It was developed with input from clinical safety, governance and delivery teams across NHS England. It brings together established writing standards and findings from user research into how NHS messages are read and understood.
It sits alongside the Messaging best practice section of the NHS England website so teams can plan, write and send messages in a joined-up and consistent way.
Writing effective messages
When writing your message always consider the needs of the patient, any clinical safety requirements and the channel you are using to send the message.
To write messages in any channel:
- use plain simple English and our voice and tone
- keep messages short and concise as they'll be easier for the reader to scan
- start with the most important information
- use short, descriptive titles or subject lines
- try to avoid more than one call to action but if you cannot, make it clear which is the priority
- only include links when they are necessary and have a clear purpose
- test your messages with users before sending them
Writing for different channels
If your service has a fallback strategy you may be required to write the same message for multiple channels.
Writing messages specifically for the channel means users are more likely to understand and engage with important health-related requests or advice. For example, copying and pasting the contents of a letter into a text message or NHS App message is bad practice as this can create formatting issues and could result in a poor user experience.
Find out how to write for different channels by referring to the specific channel guidance and examples on this page. The examples illustrate how this guidance can be applied in practice. You should test your messages to make sure they meet the needs of your users.
NHS App messages
The NHS App is a free and secure way to communicate with patients and the public. Consider the following when writing messages for the NHS App.
Greeting
If you start your message with a greeting make sure you use "Dear" followed by the patient's name and not "Hi" or similar.
Choosing which name to use depends on the context of the message. Use a first name when you want to be more encouraging or conversational. For a more formal or reassuring tone consider using a full name.
- conversational tone – "Dear ((firstName))"
- reassuring tone – "Dear ((firstName)) ((lastName))"
Avoid using just a last name or first name without a greeting as it can sound impersonal.
Protecting people from spam and phishing
To access messages in the NHS App, patients need to go through NHS login and prove their identity. This means NHS App messages are more secure than email messages or text. Research has shown patients are more likely to trust links in the NHS App, and because the NHS App is secure you can use text links rather than having to write out the full URL as in a text message or email.
Find out how to use text links and URLs in an NHS App message on the NHS Notify website.
Telling patients who your message is from
Patients and the public are more likely to trust a message if they know who sent it. You can choose the sender name that is displayed with your NHS App message when you onboard with NHS Notify.
Your sender name can help patients quickly identify your service, for example "NHS vaccination invitations", "NHS App" or "Tree Tops Medical Practice". Due to the way sender name is displayed in the NHS App it is not necessary to use a signature at the end of your message.
Read more about sender names on the NHS Notify website.
Length of message
NHS App messages can be up to 5,000 characters including spaces, but research shows some patients will only read the first part of the message.
Make longer messages easier for your reader to scan by:
- keeping messages concise
- putting the important information first
- breaking longer content into short paragraphs or steps
- using bullet point lists and section headings
NHS App message examples
Text messages
Make sure text messages are brief, direct and contain a clear action that patients can follow. Use simple language and avoid unnecessary detail that may make the message too long or unclear.
Greeting
For brevity and to save characters, text messages do not always require a formal greeting. Start your message with the patient's first or full name as people are more likely to trust a text message if it is personalised.
You can consider a formal greeting if it matches the required tone or content of your message.
Protecting people from spam and phishing
Patients are more likely to read and engage with your message if they are confident it is from the NHS. There are ways you can make it easier for them to correctly recognise a genuine NHS message.
Do
- include the name of your service or organisation
- reference an event they may be familiar with such as an appointment or test
- ask someone to check your messages for errors before you send them
Don't
- do not include spelling mistakes, grammatical errors, inaccuracies or poor formatting
- do not use abbreviations or acronyms the patient may not be familiar with
If you include links in your text message make sure they:
- go to trusted sites such as NHS.UK or GOV.UK
- are human readable, for example, http://www.nhs.uk/tests-and-treatments
- include the full URL
- do not contain any personal information such as the patient's name or NHS number
- are consistent across all your messaging channels so people can check them independently
Formatting
Text messages do not support formatting such as bullet points, numbered lists, bold text or headings. If you are condensing a longer message into a text message, make sure it works without formatting. Use paragraph or line breaks to make text messages easier to read.
Find out more about message formatting on the NHS Notify website.
Telling patients who your message is from
The text message sender name (also called SenderID) shows the reader who the text message is from and is often the first thing they see when reading a text notification. If you choose a recognisable SenderID, they can quickly tell who the message is from and are more likely to open and read it.
Read more about text message sender names on the NHS Notify website.
Length of message
If a text message is longer than 160 characters including spaces, it will be charged as more than 1 message. Some signs and symbols count as 2 characters. Using accented characters may also increase the cost of your text message.
Find the cost of sending text messages with NHS Notify.
Text message examples
Emails
Emails are a cost-effective channel for longer messages, but keep them brief and direct and include a clear action that patients can follow.
When sending an email:
- keep subject lines short and descriptive
- avoid attachments
- send from official NHS domains such as @nhs.net or @nhs.uk
- use formatting such as headings and lists if it makes the message easier to read
Greeting
Patients are more likely to engage with a message that's relevant and clearly meant for them. If you start your message with a greeting you should use "Dear" and not "Hi" or similar.
Protecting people from spam and phishing
Patients do not trust emails with poor formatting, spelling mistakes, grammatical errors or inaccuracies. Write messages that follow our voice and tone. Consider asking someone to check your messages for errors before you send them.
Further ways to protect people from spam or phishing:
- avoid making requests for personal information, like a patient's date of birth, in the content of your messages
- only include recognisable links to trusted websites such as the NHS.UK or the GOV.UK websites
Telling patients who your message is from
When sending an email, there are several ways to tell the patient who it is from. Use an email sender name that clearly represents your NHS organisation or service. You should also use this name at the end of the email.
Yours sincerely,
NHS vaccination invitations
Read more about email sender name and from email address on the NHS Notify website.
For the email subject line use something specific like "Your GP appointment reminder" or "NHS vaccination invitation" rather than a generic "NHS invite". Keeping subject lines short will make your email stand out in a patient's inbox and is more likely to be opened and read.
Email message examples
Paper letters
Letters allow for longer messages and you can format the text to include headings and bullet points. They are available in large print and braille, which makes them more accessible for some patients. There may also be legal or clinical safety reasons for using letters.
Letters are expensive to send and a digital alternative should always be considered.
Find the cost of sending letters with NHS Notify.
Greeting
Letters tend to be more formal so start your message with "Dear" and not "Hi" or similar. Including a greeting is important as it builds trust.
Telling patients who your letter is from
Consider displaying your service name in a header as well as in the signature, so patients can quickly recognise who the letter is from. For consistency this should match the name used in your NHS App messages, emails or text messages.
Formatting and templates
You can format your letter to include bullet points, numbered lists, bold text, headings and more.
If you are using NHS Notify to send your message you can download a letter template, which has further guidance on writing letters.
Find out more about formatting and letter templates on the NHS Notify website.
Paper letter examples
Supporting accessibility and inclusion
Your message should use language that is inclusive and respectful.
See our section on inclusive content.
Generally, digital channels can be made accessible through assistive technology. Letters sent through NHS Notify are available in accessible formats including easy read and braille.
Read more about accessible formats when sending messages through NHS Notify.
All NHS web pages and content should follow the principles in our accessibility guidance.
Help us improve this guidance
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If you have any questions, get in touch with the service manual team.
Updated: February 2026