12,000 referral letters to GPs ‘missing’ from new electronic health system 

Thousands of referral letters from specialists to GPs in Northern Ireland have gone ‘missing’ from a national electronic health system before they could be delivered. 

Health minister Mike Nesbitt confirmed that 12,000 patient letters from consultants sent through Encompass were never delivered to GPs, although he said there were no patient safety implications from this. 

Encompass is not used in primary care but is ‘fully live’ across all trusts in Northern Ireland and ‘provides a single digital health and care record for every citizen’, according to the Department of Health. 

It was revealed in the Northern Ireland Assembly on 2 June that Encompass wrote to GPs to inform them of the missing letters. 

Speaking in the assembly, Stewart Dickson, Member of Northern Ireland Assembly (MLA) for East Antrim, said: ‘The regional Encompass team recently wrote to GPs expressing concerns that some 12,000 red-flag letters and other pieces of correspondence seem to have gone missing from the system.  

‘GPs are very rightly concerned that they are not getting the appropriate feedback from Encompass about their patients. That is a matter of serious concern. I have a letter from a GP complaining about 12,000 letters, some of which are red-flagged and some of which are downgrades, and they simply have not got them.’ 

Mr Nesbitt said he was ‘aware’ of the issue and apologised, conceded it was ‘not an acceptable situation’. 

He said: ‘Apparently, there were two fail-safes that failed, so, by definition, they are not fail-safes. The only assurance that I can give people is that, while it is unacceptable that that happened, those were referrals that were rejected by consultants. So, no physical harm was done. 

‘Obviously, if you are waiting for the result of your referral, and it is assumed that your GP has that information, that is not an acceptable situation. Work is ongoing to investigate the matter, but there were failures in the process. I accept that and apologise for it.’ 

Pulse has reported extensively on undelivered patient letters to GPs in England. In 2024, Pulse revealed hospital trusts had failed to deliver at least 724,000 patient letters to GPs, in several almost identical incidents.

And yesterday Pulse exclusively revealed a situation where 25,000 letters are waiting to be typed at a hospital trust due to workforce shortages.

Pulse has contacted the NI Department of Health and Encompass to comment.