The use and limitations of SMS reminders to improve outpatient attendance rates.

Missed appointments and non-attendance at outpatient clinics are a major cause of inefficiency in the health service. It is estimated that this problem currently costs the Health Service Executive (HSE) up to €33 million annually; each individual non-attendance costs €80 and adds a burden to lengthening waiting lists and a potential delay in assessment and treatment of the non-attending patient. Outpatient Breast Services are currently under particular pressure with a 60% increase in referrals to the Symptomatic Breast Units (SBU) since services were centralised under the auspices of the NCCP in 2007 1 .