The number of patient referral letters that went missing due to a breakdown in Northern Ireland's new healthcare electronic data system, Encompass, could be close to 50,000, an MLA has suggested.
Health Minister Mike Nesbitt told the Northern Ireland Assembly on Monday that he could not confirm that total, but stated it was a “significant number”. Earlier this month, it emerged that thousands of letters had gone missing after a fault with the Encompass system.
What is Encompass?
Encompass is a single electronic record for patients, which has been rolled out in health settings across Northern Ireland. When launched in May 2025, Mr Nesbitt said the integrated care record system would put Northern Ireland at the “forefront of health service delivery”. It was described as a clinically and operationally led integrated care record system that allows for a single digital record for every citizen in Northern Ireland who receives health and social care.
Questions in the Assembly
During question time at the Northern Ireland Assembly, DUP MLA for north Antrim Paul Frew asked the minister to outline the scale of the problem with “lost letters to GPs and patients”.
Mr Nesbitt said: “Yes, there was a failure, a technical failure, as I understand it, in what should have been a fail-safe. So, a number of referrals were not issued, and that’s a matter of deep regret for me. However, these were referrals that were telling GPs that the consultant who was issuing the referral did not need to see the patient.”
Mr Frew said: “Can he tell us the scale of the issue? I’m led to believe that it’s just under 50,000 letters. Can the Health Minister confirm that number?”
Mr Nesbitt responded: “I can’t confirm that number, because I’m told that there was a bit of duplication involved in the numbers. It was a significant number, in fact one is one too many, because Encompass is an incredibly expensive system and it just should not be happening. And although the referrals were negative in terms of the consultant saying I don’t need to see your patient, there may be occasions when the consultant was saying, but you may want to consider some other course of action. So, we should not be in any way dismissive of the breakdown and Encompass. The question that I’m still asking is on top of a system failure, in terms of the machinery, was there was a human error as well?”
Impact and Investigation
The lost letters are referral letters that inform GPs that a consultant has decided the patient does not need to be seen. However, some letters may have included suggestions for alternative courses of action, meaning the failure could have affected patient care. The minister expressed deep regret over the technical failure and indicated an investigation is ongoing to determine if human error contributed to the problem.
