The NHS Notify service was created in response to growing demands for more efficient, scalable, and cost-effective communication within the National Health Service England (NHSE).
Launched in mid-2023, NHS Notify is a centralised platform that enables NHSE programs and services to send personalised messages and communications to citizens across multiple channels. The platform was initially designed to replace existing technology for vaccination programs but has since expanded to support various NHSE communications, in doing so, helping to reduce costs and improve patient engagement.
In this case study, we outline how Hippo’s user-centred approach to product and delivery has supported the transformation of patient communications for NHSE.
The client and service
NHS England (NHSE) is responsible for delivering high-quality healthcare services to citizens across the country. As part of its commitment to improving digital communication with patients, NHSE introduced NHS Notify—a central platform aimed at streamlining how healthcare programs connect with citizens.
NHS Notify ensures that health information reaches citizens through the most effective and efficient channels, including the NHS App, email, SMS, and letters. Since its launch in 2023, the service has played a pivotal role in improving the reach and reliability of NHSE’s communication campaigns, particularly in areas such as vaccination, screening, and referral programs.
The challenge: Redefining how NHSE connects with patients
A key driver for NHSE, alongside ministerial commitments, was a goal to reduce the substantial costs associated with physical mail and prioritising digital communication (primarily through the NHS App), whilst improving the speed and consistency of communication with citizens.
Communication with citizens had previously contributed to a large number of complaints in the NHS. A key element of the work was to design a service that drives effective messaging and communications. This involved:
- Ensuring people receive information in a timely manner and in a way that they can access and consume.
- Prioritising notifications through the use of the NHS App, but still ensuring that citizens are contacted through alternative channels should they not have access to the App.
- Embedding accessibility and inclusivity considerations into the design and format of notifications.
- Delivering standardisation of communication design through consistent NHS branding, creating common layouts, and instilling trust in digital comms.
The solution: Rapid delivery underpinned by user-centred principles
The NHS Notify project was delivered by a multi-disciplinary team of Hippos and colleagues from BJSS (now CGI) and NHSE, comprising user researchers, designers, product managers, and engineers.
The team has expanded at pace to meet the complex needs of the project. Starting with a small team at the end of 2022, the capability delivered by Hippo grew at pace to meet the complex needs of the service and now includes a holistic user research and design team with specialists in content, UX, and service design. Specialists in delivery management, product management, business analysis, onboarding and data are also now guiding the wider programme of work.
Scaling delivery with a user-focused approach
By integrating strategy, customer experience, product design, and engineering, Hippo has been able to meet the evolving needs of both NHS organisations and citizens. Starting with just one user researcher in December 2022, the team quickly expanded by April 2023 to include service designers, content designers, and a product manager. As the project’s complexity increased, so did the resourcing, with Hippo now leading a full research and design function alongside delivery managers, product managers, business analysts, an onboarding manager, and data specialists across four teams.
To support this growing complexity, we introduced formal customer segmentation and standardisation. This strategic clarity on what we support for each customer type has since evolved to include dedicated sector leads, who are instrumental in refining our understanding of each sector’s unique needs and enabling a stronger product offering.
Adopting a flexible, iterative model, the team was able to:
- Release and refine the MVP throughout 2023, enabling continuous improvement
- Respond to emerging needs and onboard new users in real-time
- Focus on developing a comprehensive and scalable web interface for NHS Notify by Spring 2025
Delivering user-centred design at scale
User-centred design was critical to NHS Notify’s success. Through comprehensive user research, we identified communication needs that shaped product development and feature prioritisation, including enabling new messaging channels and enhancing integration capabilities. Hippo also refined onboarding processes to keep pace with rising user demand.
The platform’s robust technical infrastructure ensures secure, reliable message delivery, even under high demand, and is designed to scale effectively for national health campaigns while maintaining performance and security across diverse use cases.
Since June 2024, data analysts have worked alongside the team to refine performance monitoring tools, ensuring the platform’s scalability and responsiveness as user demand continues to grow. They are also working to understand more about the way users interact with the service and send messages.
Building inclusivity and sustainability into the design
Accessibility and sustainability were integral to the approach. Working with the RNIB and other partners, the project team enabled braille and audio versions of communication templates for visually impaired users. Integration with PDS language data also allows messages to be sent in recipients’ preferred languages, expanding the service’s reach.
Hippo also worked closely with suppliers to ensure that physical communications were produced using environmentally friendly materials, such as recycled paper and sustainable envelopes. By aligning supplier practices with strict environmental standards, the project was able to reduce its carbon footprint while maintaining a focus on long-term sustainability.
The outcome
NHS Notify has significantly streamlined communication processes for NHS England (NHSE), eliminating the need for individual communication suppliers across services. By centralising messaging procurement, the platform leverages economies of scale to reduce SMS and letter delivery costs, offering a more cost-effective solution for NHSE.
Currently, the service is free for users, with no charges for support functions or infrastructure costs associated with Notify itself. This means that email and NHS App messaging are completely free to the user, delivering a seamless experience without additional financial burden.
From a technical perspective, the platform’s design has enabled the team to build a highly cost-effective solution capable of scaling from hundreds of daily communications to tens of millions during national health campaigns. The use of cloud-based infrastructure (AWS hosted) has facilitated accelerated delivery, ensuring the platform is easy to maintain and can meet the evolving demands of NHSE’s communication needs.
Some of the key technical features include:
- Scalability: The system can support simultaneous senders without compromising performance, even during peak demand.
- Reliability: The infrastructure ensures secure and efficient message delivery while maintaining high performance.
- Cost-efficiency: The solution standardises message delivery at market rates, driving further savings.
- Multi-channel delivery: The platform supports multiple communication channels (SMS, email, NHS App, letters), enabling both individual and national-level outreach.
By improving the delivery and reach of messages, NHS Notify has contributed to higher engagement and appointment uptake. While the national campaigns notify users about vaccination availability, and GP surgeries send separate communications, the platform has undoubtedly played a pivotal role in enhancing message effectiveness and increasing response rates.
In 2024, NHS Notify successfully delivered 81.5 million messages across letters, email, SMS and the app. This contributed to cost saving for the NHS of £9.1 million across their messaging platforms. In 2025 the benefits reached approximately £33 million through digitisation and procurement combined.
The savings generated from switching to digital-first communications are already enabling NHSE to reinvest in other services, with tens of millions more in cost reductions expected over time.
What’s next?
Looking ahead, NHS Notify will continue to evolve with the release of new features and ongoing iterations to further enhance the service.
Key upcoming feature developments include:
- Web UI for user-driven management: Empowering users to independently manage their content and configurations, streamlining the process and reducing reliance on support teams.
- Enhanced reporting and performance analytics: Providing more granular insights to help NHS organisations track messaging effectiveness and optimise communications.
- Optimising backstage processes: Simplifying internal workflows to reduce manual tasks, allowing the programme team to focus on strategic priorities and further service enhancements.
Alongside this, the NHS Notify service was launched to its first primary care users in January 2025 with further expansion on the horizon. The team is also currently conducting research with secondary care users.
These upcoming enhancements will continue to refine NHS Notify, ensuring it remains a vital tool for efficient, scalable communication across the NHS. As the platform evolves, it will better serve both healthcare providers and citizens, driving further improvements in patient engagement and service delivery – allowing millions of people in England to access the service.
