Breast cancer: South Eastern Trust 'Encompass' system adds to delays

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The health trust said it understood that the "delay will be distressing for patients"

Women waiting for first breast-cancer assessment appointments with the South Eastern Trust have had appointments delayed due to a new patient record system, BBC News NI has learned.

One woman, red-flagged after finding a lump, said the wait was "torture".

In a statement, the health trust said it understood that the delays will be "distressing for patients".

It added that following assessment treatment will be offered as "quickly as possible".

The Department of Health's target for breast-cancer referrals is two weeks.

The 67-year-old woman who contacted BBC News NI has been waiting seven weeks after being red-flagged by her GP.

The woman, who wishes to remain anonymous, said the system was a mess.

"I have a lump in my breast, my mum died from breast cancer, there is a history of breast cancer in my family, it's the waiting that will kill me," the woman said.

The woman, who lives in the South Eastern Trust area, said she had been offered an appointment at a breast-cancer clinic at Altnagelvin, but there was no follow-up call to confirm a time.

"I have no problem travelling to another health trust, I would travel hundreds of miles to be examined, but sadly no-one came back to me." she added.

The South Eastern Trust said that the launch in November of 'Encompass', the new patient record system, had "regrettably it had temporarily lengthened" some appointments.

BBC News NI can also reveal that there are 378 red-flag breast patients waiting to be seen in the South Eastern Health Trust.

A red-flag referral means the patient needs timely investigations to rule out the possibility of cancer.

There has been a significant increase in demand for breast cancer assessment.

To cope with demand in the past 12 months the South Eastern Health Trust sent urgent patients to other health trusts for assessment:

  • 119 to the Belfast Trust

  • 96 to Altnagelvin's hospital's triple assessment breast clinic

  • 40 to the Southern Trust

  • 30 to the Northern Trust

Over the next two years all five local health trusts are due to implement the regional 'Encompass' patient record system.

The South Eastern Health Trust said that means "further temporary downturns in activity may be experienced".

Image source, Pacemaker
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Ninety-six patients have been sent to Altnagelvin Hospital by the South Eastern Trust in the last 12 months

"The South Eastern Trust is working tirelessly with our regional colleagues, to reduce the number of patients waiting for red-flag breast assessments, as we completely understand the distress this can cause not just to them, but also to their families," it said.

"This is not the service we want to provide for our patients.

"While the introduction of the regional encompass digital patient record system has had a temporary, limited impact on the number of patients who can be seen, the main reason is the surge in demand, compounded by staff shortages.

"Since 2020/21 there has been a 26% sustained increase in the number of red-flag breast referrals to the trust. This rise in demand is an issue which is being experienced across all health trusts.

"It is important to note that a red-flag referral is to rule out cancer and on average, 3% of breast assessment patients will be diagnosed with cancer."

'Absolutely diabolical'

Macmillan Cancer Support has described the delay as "extremely worrying".

Its policy and public affairs manager, Sarah Christie, said: "I think it is absolutely diabolical to find that people are waiting even longer because of a system roll-out - we should have had safeguarding in place to mitigate against this.

"I think there's urgent lessons that need to be learned in terms of this rollout.

"Encompass is important, we need system transformation, but not at the detriment to people waiting to find out if they have cancer."

A spokesperson for the Western Trust said: "The Western Trust has been supporting the South Eastern Trust with their current challenges in red-flag breast referrals.

"It was agreed that the Western Trust would assist with providing two assessments only 'mega clinics' for South Eastern Trust patients, to be held at Altnagelvin Hospital.

"One of these clinics took place on 9 March with 100 South Eastern Trust patients being assessed. A further mega clinic will be taking place in the coming weeks."

"A significant staffing resource is required to facilitate the clinic from surgery, pathology, and radiology.

Research carried out by an independent group of experts on the healthcare systems in the UK and the Republic of Ireland said NI waiting list statistics are "shameful for senior healthcare managers here and dangerous for the wider population, as it is acknowledged that long waits increase the risk of death".

"Benchmarking Northern Ireland Health Care Performance", carried out by an independent group of experts, said that cancer services are an important case in point, having not kept pace with rising demand, promises of improved cancer care for patients in Northern Ireland "ring increasingly hollow".

The Northern Ireland Audit Office commissioned the research, but said the findings had not been verified by them.