“Missed appointments cost �19.8m” is the headline that greeted readers of ‘This is Oxfordshire’ on the 4th of September. A local hospital was losing nearly £20m pounds due to missed appointments. More recently, the British Prime Minister, Tony Blair previously announced that “missed outpatient appointments alone cost the NHS around �250 million a year”.

Unfortunately the cost is not just counted in monetary terms but also in lowered quality of service at clinics and hospitals. If those that no longer need care simply rang to cancel appointments, existing patients could receive attention more quickly. While many clinics and hospitals plan for missed appointments by scheduling a number of patients at the same time - this approach can lead to frustration.

The repercussions for some patients who miss appointments can be fatal. A report in CHEST - The Cardiopulmonary and Critical Care Journal, April 12, 2001 showed that “the death rate soared to 27% for lung volume reduction surgery (LVRS) patients who” did not attend follow up appointments compared to only 3% for those that did attend.

Some work has been undertaken to evaluate different methods of encouraging patients to attend or notify clinics of cancellations. “A Method for Decreasing Missed Appointments” in Family Practice Management, February 1997 showed that calling to remind patients of appointments dramatically improved attendance figures.

SmartNote allows clinics and hospitals to schedule the delivery of text messages (SMS) hours or days before a patient is due to attend an appointment. Messages are fully automated and can arrive 24 hours a day. The SmartNote team can offer a range of implementation from a web based interface to custom integration with existing IT infrastructure. All of these services are available and keenly competitive rates - minimising the time to realise a return on investment.