Exclusive: Urgent reviews underway as cancer referrals caught up in Encompass IT problems - MLA brands failings 'horrific'

DUP MLA Paul Frew, who has been questioning Stormont’s health department (DoH) on the issue for months, has described the failings as “horrific”.

It relates to problems with the £400m Encompass system, an attempt to streamline and modernise patient records across Northern Ireland’s health trusts.

Officials admit that some GPs “may not have received confirmation of the triage outcome as intended” – and says “higher-risk cases” are being prioritised as part of “urgent reviews” by the trusts.

According to a probe carried out by the department 44,657 referrals have so far been affected – 16,366 of them urgent and 1,423 suspected cancer referrals.

Mr Frew told the News Letter: “This is horrific. My worst fears have been confirmed and realised.

“Encompass was extremely expensive; it was supposed to be fail safe. This shouldn’t have happened, a complete systems failure that will cause torment for those people impacted.

“To make it worse we now know that out of the 44,657 affected referrals 16,366 were urgent referrals and 1,423 were suspected cancer referrals. Think of the anguish this failure will have caused.”

A DoH spokesperson said: “The department is continuing to work with the regional Encompass team and trusts to address issues affecting some GP referral rejection letters. While referrals were received and assessed, some GPs may not have received confirmation of the triage outcome as intended.

“Patient safety remains the priority, and trusts are carrying out urgent reviews, prioritising higher-risk cases.

“Further information will be provided once the figures and any patient impact have been validated.

“HSC teams continue to work together to review and improve referral workflows and processes with departmental oversight.”

When the Encompass system was launched, it was branded as “a system designed and built by our people, for our people”, with the aim of becoming a “digital health and care record for every citizen in Northern Ireland”.

At the end of June, Mr Frew raised issues with the Encompass system with the previous health minister Mike Nesbitt at Stormont. Just before he stood down, Mr Nesbitt provided the DUP man with a written response to his concerns.

In it, the minister said: “The issue concerns circumstances where referral rejection communications were not returned to referring GP practices as intended following clinical triage decisions. It does not relate to referrals being lost within Encompass.

“The referrals concerned were received and triaged within the system, however the communication informing the GP of the outcome was not always generated or issued as intended.”

The health minister said there were “two distinct components” to the issues with Encompass. The first was a “technical system issue affecting the generation of rejection communications between November 2025 and May 2026, which was previously identified and reported”.

He said that a subsequent investigation “identified a separate cohort of earlier cases dating back to trust go-live periods, where referral rejection communications were not consistently issued due to local workflow and process factors”.

“The latest validated information available indicates that a total of 44,657 referrals were affected across the period identified to date.

“These figures remain subject to further validation by HSC trusts and the regional Encompass team and may therefore be subject to revision. This includes 16,366 urgent referrals and 1,423 suspected cancer (2WW) referrals,” the then minister said.

He said the November 2025 to May 2026 cases were “primarily associated with a technical issue affecting the generation of referral rejection communications, which was addressed through a system correction implemented in April 2026”.