Health Minister Apologises for Missing Referral Letters
Health Minister Mike Nesbitt has issued an apology following the disappearance of approximately 12,000 patient referral letters from the new electronic healthcare records system.
General Practitioners (GPs) had referred thousands of patients for further examinations related to potentially serious or life-threatening conditions, but no subsequent communication was received by either the patients or their GPs.
The issue with the Encompass system has persisted for over six months but has only recently been disclosed.
Nesbitt stated that the letters in question were "rejections," indicating that medical specialists had determined the patients did not require further consultation.
However, the BBC has learned that some patients’ outcomes remain unresolved.
GPs make "red flag" and urgent referrals to specialist consultants when they suspect patients exhibit alarming symptoms warranting immediate investigation.
NI reviewed a patient letter that neither the patient nor the GP had received.
Although the letter indicated that the red-flagged referral had been rejected, it also instructed the GP to pursue an alternative investigative pathway for the patient.
This gynaecological referral was made in April 2026, but the information was never communicated.
Encompass is intended to serve as a unified electronic record accessible by most healthcare professionals.
Nesbitt commented:
"I am aware of this (issue) and I have discussed it with the digital team, and apparently there were two fail safes that failed - so by definition they are not fail safes.
"The only assurance I can give people is that, while it is unacceptable that this happened, these were referrals which were rejections by consultants, so no physical harm was done.
"But obviously if you are waiting for the results of your referral, and the GP presumes that you have already got that information, that is just not an acceptable situation.
"Work is still ongoing in terms of investigating, but there were failings within the process, and I accept that and apologise for it."
Letters Not Sent
NI understands that over 12,000 referral letters, either rejected or downgraded since November 2025, have been affected.
Reasons cited include patients residing outside the boundaries of specific health trusts.
One GP expressed concern that individuals may have been unjustifiably removed from hospital waiting lists without notification to themselves or their GPs regarding the outcomes.
After inquiries to each health trust, NI was directed to contact the regional Encompass programme management directly.
In a letter to GPs reviewed by the BBC, the Encompass team acknowledged that referral rejection letters, which should have been automatically generated, were not sent to patients.
This automatic letter creation ceased on 8 November 2025, and the team committed to resending correspondence to GPs, prioritising red flag and urgent cases.
Serious Concern Raised
Alliance Party assembly member Stewart Dickson addressed the assembly:
"GPs are very rightly concerned that they are not getting the appropriate feedback from Encompass about their patients.
"This is a matter of serious concern. I've got a letter here from a GP complaining about 12,000 letters - some of which are red flag, some of which are downgrades, and they simply haven't got them."
Separately, the health minister informed the assembly that the Department of Health is preparing a warning for healthcare workers regarding the use of the Encompass system for voyeuristic or inappropriate purposes.
Nesbitt stated:
"The difficulty is, will people who have access to Encompass be using it - I'm going to use the word prurient - or in a voyeuristic way?
"I have been in discussions with our digital team, and we have now come up with a warning that will appear on the home screen every time somebody logs into Encompass, to warn them that inappropriate access of information could result in disciplinary action, and in fact could result in criminal prosecution."
