EMMA is Sending a Text Message the Practice Did Not Request

Purpose of Document

Practices occasionally contact support to report that patients are receiving unexpected text messages they did not request or approve. In most cases these messages are legitimate platform behaviour. Staff must be able to explain clearly why patients receive SMS messages, identify the specific trigger, and determine whether it represents a misconfiguration that needs investigation.

Background: Why EMMA and SOPHIA Send Text Messages

There are several distinct scenarios where the platform sends an SMS to a patient. Each has a different trigger and a different purpose. Understanding which scenario applies is the first step in responding to a practice complaint.

Scenario 1: SOPHIA continuation link (eConsult surgeries)

When a patient calls an eConsult surgery, EMMA may send the patient an SMS containing a SOPHIA link. This allows the patient to continue their request in writing via the SOPHIA web interface rather than staying on the phone. This is core to how the eConsult flow works and is expected behaviour.

As of February 2026, patients receive a single SMS invite rather than multiple notifications. This improvement was made to reduce patient confusion and make communication feel more professional.

As of March 2026, SOPHIA sends one of two scenario-specific messages:

A disconnected-call message when the call drops unexpectedly
A neutral continuation message for all other scenarios including caller choice, poor call quality, or practice-directed SOPHIA flows

Scenario 2: Lifeline fallback link (V12, all surgeries)

As of EMMA V12 (April 2026), EMMA tells every caller at the start of the call that if the line drops or their signal is poor, they will receive a secure link to continue their request through SOPHIA. This is called Lifeline. If the call subsequently drops or the patient disconnects, EMMA sends an SMS with a secure SOPHIA link so the patient can pick up exactly where they left off. The practice receives the same structured outcome and nothing is lost.

This is expected behaviour introduced with V12 and applies to all surgeries, not just eConsult surgeries. Practices may notice an increase in SOPHIA submissions from patients who previously would have called back. This is by design.

Scenario 3: Pathways NHS App deep link (V12, repeat prescriptions)

As of EMMA V12 (April 2026), when a patient calls about a repeat prescription, EMMA explains that repeat requests must be made in writing in line with NHS guidance. EMMA then sends the patient a secure deep link to the NHS App by SMS so the patient can complete the request digitally. This is the Pathways feature.

Pathways falls back intelligently to SOPHIA, to the reception team, or to the practice website if the patient cannot use the digital route. Practices may report that patients are receiving NHS App links they did not expect. This is correct V12 behaviour and should be explained to the practice as a feature that supports NHS App adoption targets.

Scenario 4: Silent caller SMS continuation link (mobile callers)

As of April 2026, when a caller goes silent and EMMA cannot re-engage them, mobile callers automatically receive an SMS continuation link via SOPHIA. Landline callers receive verbal next-step signposting instead. All disconnect messages include 999 and 111 signposting for callers with urgent needs.

Practices may notice patients receiving texts after silent or dropped calls. This is expected platform behaviour introduced alongside the improved silent caller handling update.

When SMS Messages Are NOT Expected

Accurx surgeries receiving eConsult SMS messages

Before 27 April 2026, patients calling Accurx-configured surgeries were occasionally receiving an incorrect message telling them they would receive a text message with a link. This message was intended only for eConsult surgeries and should never have been presented to Accurx callers. In some cases callers were also pushed into an eConsult SMS verification flow that was irrelevant to their surgery, and calls ended early via the eConsult goodbye path.

This was resolved on 27 April 2026. The fix ensures:

Accurx callers never hear the eConsult signposting message
Accurx callers never enter the eConsult SMS verification flow
The eConsult signposting message is strictly restricted to eConsult surgeries only and cannot be triggered for Accurx, Anima, or any other consultation tool type
The fix was verified across edge cases including online triage requests, repeated reception requests, and cases where the conversation became unclear

If a practice using Accurx is still reporting patients receiving unexpected SMS messages after 27 April 2026, this must be escalated to engineering immediately.

Common Causes and What to Check

1. The practice is an eConsult surgery and is not aware that SOPHIA SMS is part of the standard flow

This is the most common cause. Practices sometimes go live without fully understanding that SOPHIA SMS messages are a core part of the eConsult patient journey.

What to do:

Confirm the practice's consultation tool
Explain that for eConsult surgeries, SOPHIA SMS is part of the expected call flow and is not optional
Reassure the practice that the messages are sent to help patients complete their request and reduce repeat calls to the surgery
Share the relevant patient-facing explanation if needed

2. The practice is on V12 and is not aware of Lifeline or Pathways

Practices on V12 may notice SMS activity they did not see before. Both Lifeline and Pathways introduce new SMS touchpoints that are part of the V12 feature set.

What to do:

Confirm whether the practice has been migrated to V12
Explain Lifeline: every patient is told at the start of the call that a SOPHIA link will be sent if the call drops. This is a safety and accessibility feature
Explain Pathways: patients calling about repeat prescriptions are sent a secure NHS App deep link by SMS. This supports NHS App adoption and is aligned with NHS guidance on repeat prescriptions being made in writing
If the practice wants to understand more about V12 features in detail, direct them to their account manager

3. An Accurx surgery is still receiving incorrect eConsult SMS messages after 27 April 2026

This should not be happening. If confirmed, it is a platform issue requiring immediate investigation.

What to do:

Confirm the surgery's consultation tool is Accurx
Confirm the date of the affected calls
If after 27 April 2026, escalate to engineering immediately with the surgery ODS code, affected call IDs, and a description of the message the patient received

4. A patient received two SMS messages instead of one

Before February 2026, patients could receive multiple SOPHIA invite notifications. This was resolved and patients now receive a single SMS invite.

What to do:

Check whether the incident predates February 2026
If occurring after that date, escalate to engineering with the affected call ID and surgery ODS code

Step-by-Step Triage Process

Ask the practice which consultation tool they use: eConsult, Accurx, Anima, AskMyGP, System Connect, or Klinik.
Ask the practice to describe what the SMS message said and when it was received.
Match the message to the relevant scenario: SOPHIA continuation link, Lifeline fallback, Pathways NHS App deep link, or silent caller continuation.
If the practice uses Accurx and the message appears to be an eConsult SMS signposting message, confirm whether this occurred before or after 27 April 2026.
If the message cannot be matched to any known expected scenario, or if it is occurring on Accurx after 27 April 2026, escalate to engineering.

What to Tell the Practice

Keep communication reassuring and clear.

Example wording for eConsult and SOPHIA continuation messages:

"The text message your patient received is part of how EMMA handles calls where the patient may benefit from continuing their request in writing. It is a built-in accessibility feature and does not indicate a fault. The message gives the patient a secure link to complete their request without needing to call back, which helps reduce repeat calls to your surgery."

Example wording for Lifeline:

"As part of our V12 release, EMMA now tells every patient at the start of a call that if the line drops, they will receive a secure link to continue their request. This is our Lifeline feature. It ensures no patient is ever stuck if their signal is poor or their call drops unexpectedly."

Example wording for Pathways:

"As part of our V12 release, EMMA now sends patients calling about repeat prescriptions a secure NHS App link by SMS. This is in line with NHS guidance that repeat requests should be made in writing, and it supports your surgery's NHS App adoption targets. The patient receives one message and can complete their request in a few taps."

Common Mistakes

Treating all unexpected SMS messages as a fault without first identifying which scenario triggered them
Not checking the surgery's consultation tool before investigating
Telling a practice that SOPHIA SMS is optional for eConsult surgeries
Not being aware of Lifeline and Pathways as new V12 SMS touchpoints that apply to all surgeries
Failing to escalate promptly when an Accurx surgery reports eConsult SMS messages after 27 April 2026

Escalation Guidance

Escalate to engineering if:

An Accurx surgery is receiving eConsult signposting SMS messages after 27 April 2026
A patient received multiple SMS messages after the February 2026 single invite fix
An SMS message cannot be matched to any known platform trigger
A patient is receiving NHS App deep links but the surgery has not been migrated to V12 and Pathways

When escalating, always include:

Surgery name and ODS code
Consultation tool used
Affected call ID and timestamp
Description of the message content the patient received
Whether the incident predates or postdates the relevant platform fixes

Last Reviewed: May 2026 Owner: Support and Customer Success