New ACMA SMS rules now in force — could patients be missing vital updates?

With the SMS Sender ID Register having commenced this month, the general manager of a multichannel messaging company sets out why some patients may be missing vital messages.

Communication sits at the heart of modern health care. Every day, Australian hospitals and clinics send thousands of messages to patients, keeping them informed on the latest updates in their care. Health care operates in a highly regulated environment, so compliance is top-of-mind in every task and communication is no different. But a recent legislation change affecting the way healthcare organisations can communicate with their patients has introduced a new potential vulnerability — and left unactioned, puts patients at increased risk.

New rules from the Australian Communications Media Authority (ACMA) require healthcare businesses who wish to send branded text messages — that is, have their name displayed at the top of their text conversation threads — to register with the new SMS Sender ID Register. These changes came into effect on 1 July 2026, but not all healthcare organisations have made it on the register yet — and patients may miss vital messages as a result.

Why has the SMS Sender ID Register been brought in?

The SMS Sender ID Register has been brought in to help tackle the rising problem of scams — with Australians losing almost $18 million to SMS scams last year, according to ACMA.¹ A Sender ID is the name that appears on text conversation threads with businesses, organisations and other public bodies, like ‘AusPost’ or ‘myGov’. For patients, they’re a vital trust signal, helping recipients to feel confident that the person contacting them is who they claim to be.

But since 1 July, any business that isn’t on the SMS Sender ID Register has their sender ID displayed as ‘Unverified’. Many users will see this, assume the message is spam, and move on. In addition, all ‘Unverified’ messages appear on a patient’s phone in a single conversation thread, regardless of the actual number they were sent from. That means legitimate medical reminders could be mixed in with actual spam and malicious messages, and ignored by patients as a result.

A gap in comms could lead to a clinical crisis

On paper, it might seem like a minor technology and compliance issue. In practice, however, it’s an operational and clinical risk. For example, consider a patient waiting for a critical oncology appointment or a reminder to collect time-sensitive medication. If the message lands in the ‘Unverified’ message thread, it could be easily missed — with repercussions on individual health and wellbeing.

From an operational standpoint, you have further knock-on effects. Late cancellations and did-not-attends cost the healthcare system millions annually, exacerbating waiting lists and making it harder for patients to get the help they need. Additionally, we know that scammers often pretend to be from major, trusted brands — and the medical sector is one they frequently target. Health is a priority for everyone, and many scammers capitalise on that urgency and importance.

After the diphtheria outbreak earlier this year, having an efficient communication channel with the public is vital, so the stakes are high for healthcare providers to get onto the register quickly.

What providers need to do

The transition period we’re currently going through is likely the highest-risk period. There’s still a lot of uncertainty from both patients and professionals; and scammers know that confusion creates opportunities for them. For organisations, that means the time to act is now.

The first step is to work with your telco to ensure you are on the register — particularly if you have different sender IDs for different departments or sites. I’d also encourage organisations to educate their patients on the change. Existing communication channels — such as social media, newsletters or in-clinic signage — should be used to help customers understand what’s changed, how they can keep safe, and most importantly, how they know it’s you.

ACMA’s crackdown on SMS is ultimately a positive move for Australians, creating a safer ecosystem for everyone. But right now, the stakes are too high for healthcare providers to lag behind. Ensuring your messages are verified isn’t just a regulatory or an IT checkbox — it’s a fundamental component of patient care and safety.

For more information on the SMS Sender ID Register, including how to register, visit www.acma.gov.au/sms-sender-id-register.

^{1. Some text messages to look different from 1 July. Australian Communications and Media Authority (ACMA). Accessed 23 July, 2026. https://www.acma.gov.au/articles/2026-06/some-text-messages-look-different-1-july}

*Jonathan Walsh is General Manager of Esendex.

Image credit: iStock.com/izusek