Health chiefs are considering plans to send text messages reminding people to turn up for appointments because so many are being missed.

Some 46,000 people failed to show up for outpatient appointments with Brighton and Sussex University Hospitals NHS Trust in the past year out of 338,000 booked.

Some absences were legitimate - patients may have been called away to emergencies or letters confirming their appointments may have failed to reach them in time.

But many did not turn up simply because they had forgotten about the appointment or no longer needed it but did not let the hospital know.

The missed appointments are costing the trust thousands of pounds in staff time as well as impacting on already long waiting lists.

Now the trust, which is already trying to claw back an £8 million overspend, is having to consider new measures to tackle the problem, including a new booking system and the possibility of text message reminders.

Outpatients manager Gareth Hall said: "While the trust wouldn't wish people to attend hospital unnecessarily, Did Not Attends (DNAs) are a major problem for the trust and its patients.

"If we knew the appointment was not going to be taken, we could offer it to someone else.

"DNAs cause delays for other patients on the waiting list and waste money and staff time."

The trust is introducing a system which will give patients some flexibility about when their appointment will be held.

Patients who do not need urgent appointments will be asked to contact the relevant department by phone to arrange a mutually convenient date and time.

This is a significant change in practice, as patients traditionally had little or no say in the arrangement of their appointments.

The new system is being introduced gradually to all outpatient departments at the trust's hospitals in the coming months.

Further developments are planned for the next few years.

Eventually many patients will have the opportunity to book their hospital appointment before they leave their GP surgery.

In addition, the trust is exploring other ways of reminding patients about appointments, such as sending mobile phone text messages, a system hospitals elsewhere have introduced successfully.

In the meantime, all patients who are unable to keep their appointment, or no longer need it, should contact the relevant department as soon as possible.

It is estimated missed appointments cost the NHS nationally £400 million a year.