NI introduces regional breast cancer assessment system to tackle waiting time disparities

In a landmark reform to improve patient care, Health Minister Mike Nesbitt has announced the launch of a regional approach to breast cancer assessments in Northern Ireland.

The initiative, which went live this month, aims to eliminate disparities in waiting times for patients with suspected breast cancer, ensuring that clinical need, rather than geographical location, determines how quickly patients are seen.

The new system is a cornerstone of the Minister’s commitment to rebuilding a more equitable and responsive health service. It leverages the recently implemented encompass electronic patient record system, now operational across all Health and Social Care (HSC) Trusts in Northern Ireland. This digital infrastructure facilitates coordinated appointment booking and optimises the use of diagnostic capacity across the region.

Addressing Long-Standing Inequities

For years, patients across Northern Ireland have faced varying wait times for breast cancer assessments depending on their postcode.

The regional waiting list seeks to rectify this by offering patients the earliest available appointment at one of five acute hospital sites: Altnagelvin Area Hospital (Western HSC Trust), Antrim Area Hospital (Northern HSC Trust), Belfast City Hospital (Belfast HSC Trust), Craigavon Area Hospital (Southern HSC Trust), or Ulster Hospital Dundonald (South Eastern HSC Trust).

“Far too many women have waited too long, and that is simply not acceptable,” said Minister Nesbitt. “This new regional waiting list is a clear signal that we are serious about doing things differently. It is a practical, patient-focused change that puts fairness and clinical need first – not geography or outdated processes.”

The South Eastern Health and Social Care Trust (SEHSCT) oversees the regional waiting list through a centralised administrative team. Patients referred with red flag symptoms—indicating possible breast cancer—are triaged by their home Trust and then passed to the regional booking team. They are contacted directly and offered the earliest available appointment, with the option to wait for a local slot if preferred. After assessment, patients return to their home Trust for any required treatment.

A Collaborative and Patient-Centred Approach

The reform has been developed through close collaboration between clinicians, HSC Trusts, administrative teams, and patients.

“This is a change built on partnership,” Minister Nesbitt noted. “It has been achieved through genuine co-production between clinicians, Trusts, administration teams and most importantly, the patients we serve. I want to thank everyone involved for making this major reform possible.”

To support patients, travel assistance may be available for those eligible, and a new regional breast pain service is in development to reduce pressure on assessment clinics. These clinics, often described as ‘one-stop’ services, provide comprehensive diagnostics, including breast examinations, imaging (such as mammograms or ultrasounds), and biopsies when necessary.

Multidisciplinary teams, comprising breast specialists, radiologists, pathologists, nurses, and support staff, deliver this critical care.

A Broader Vision for Breast Services

While the regional system currently applies only to red flag breast cancer referrals, Minister Nesbitt has commissioned a comprehensive review of breast services to set standards for all symptomatic breast care.

“While this initiative focuses on breast cancer assessment, it represents something bigger – a step toward a more responsive, more equitable health service for everyone,” he said. “My commitment is to ensure that all patients across Northern Ireland get the care they need, when they need it, wherever they live.”

The review will explore long-term improvements in quality, equity, and sustainability across the breast cancer pathway. This aligns with the Minister’s broader strategy to address the gap between capacity and demand, invest in healthcare staff, and make better use of existing facilities.

“I’m focused on rebuilding our health service,” Nesbitt added. “This is how we stabilise, reform and transform and this initiative is a clear example of that approach in action.”

The Scale of the Challenge

Breast assessment clinics play a vital role in both symptomatic and screening referrals. According to the Department of Health, approximately 4 in every 100 women screened are referred for further assessment.

With breast cancer remaining one of the most common cancers in Northern Ireland, timely and equitable access to diagnostics is critical to improving patient outcomes and restoring public confidence in the health service.

Patients with non-red flag breast symptoms will continue to be managed through local pathways for now, but the ongoing review is expected to propose enhancements to these services as well.

A Step Toward a Fairer Future

The introduction of the regional waiting list marks a significant milestone in Northern Ireland’s health reform journey. By harnessing digital tools like the encompass system and fostering collaboration across Trusts, the initiative sets a precedent for tackling systemic inequities in healthcare delivery.

As the Department of Health continues its review of breast services, the focus remains on delivering sustainable, patient-centred care. For now, the regional approach to breast cancer assessments offers hope to thousands of women across Northern Ireland, ensuring that no one waits longer than necessary for a potentially life-saving diagnosis.

For more information on breast cancer assessments or to learn about support services, contact your local HSC Trust or visit the Department of Health website.