Nexus tracks two different things about how patients like to be contacted — and keeps them deliberately separate.
Stated preferences
What the patient has *told you*: which channels they prefer or find acceptable — email, SMS, NHS App, phone or letter. Stated preferences are recorded with an audit trail and always win when deciding how to invite a patient.
Patients can manage their own preferences from every FFT invitation we send: the footer carries a "Choose how we contact you" link alongside the unsubscribe link. It opens a short form — no login needed — where they can pick a preferred channel, mark others as acceptable, or say "don't use" for any channel. Choices are applied automatically; "don't use" goes onto the opt-out list below.
Observed engagement
What the data *shows*: response rates per channel from your actual send history — e.g. "our SMS invitations get double the response rate of email." This appears in the channel insights panel on the results dashboard.
Observed engagement is for planning only — Nexus never silently switches a patient's channel because of it. Only a stated preference changes how an individual patient is contacted.
Opt-outs
The contact opt-out list is the single authority for "do not contact" — a patient on it is never invited, whatever their preferences or engagement history say. It covers all five channels, so a patient can refuse a channel we don't send on yet (letter, say) and that refusal simply applies the moment it goes live.
Opt-outs are deliberately sticky: a later preference update never quietly lifts one. Lifting an opt-out stays a staff action on a verified request.
Practical upshot
- Upload both email and mobile where you have them — it gives the system a choice of channel.
- Use the channel insights panel to decide your default send strategy.
- When a patient expresses a preference at the desk, record it — it takes precedence from then on.
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