Health minister apologises for 12,000 missing referral letters

Health Minister Mike Nesbitt has apologised after about 12,000 patient referral letters went missing from the new electronic system which holds healthcare records.

GPs had referred thousands of people for further investigation into potentially serious or life-threatening illnesses, but they did not receive any further communication.

The situation with the Encompass system has been going on for more than six months, but has only just come to light.

Nesbitt said the letters which should have been sent were "rejections", meaning that medical specialists had concluded the patients did not need to be seen.

However, the BBC understands that some patients' outcomes have not been determined.

"Red flag" and urgent referrals are made by GPs to specialist consultants if they suspect a patient has alarming symptoms which need to be investigated.

BBC News NI has seen a copy of a patient letter which neither the patient nor GP received.

While the letter outlined that the referral which had been red flagged had been rejected, it also advised that the GP should redirect the patient down a different route for investigation.

That gynaecological referral was made in April 2026 – but the information was never communicated.

Encompass is designed to be a single electronic record for patients, which is accessible by most healthcare professionals.

Nesbitt said: "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."

BBC News NI understands that this affects more than 12,000 referral letters that have either been rejected by the health trust or downgraded since November 2025.

The reasons given include that the patient referred does not live within the boundary of a particular health trust.

One GP said there was concern that people have been unjustifiably removed from a hospital waiting list without any notification to them or their GP about the outcome.

After contacting each of the health trusts for an explanation, BBC News NI was advised to make direct contact with the regional Encompass programme management.

In a letter sent to GPs and seen by the BBC, the Encompass team said that referral rejection letters which should have been automatically created had not been sent out to patients.

This auto creation of letters had ceased on 8 November 2025 and the team would resend correspondence to GPs, prioritising red flag and urgent cases, it said.

Alliance Party assembly member Stewart Dickson told 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 told the assembly that the Department of Health was working on a warning to healthcare workers about using the Encompass system for voyeuristic or inappropriate ends.

"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?" said Nesbitt.

"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."