Northern Ireland cancer waiting times: Health Minister says regional reform already showing results

Northern Ireland’s Health Minister Mike Nesbitt has acknowledged continued pressure on cancer waiting times while insisting that early signs of improvement are already emerging following the introduction of a new regional breast assessment service.

Newly published cancer waiting time statistics for July to September 2025 capture what the Minister described as “an early stage in the transition” to the regional model, the first quarter in which all five Health and Social Care (HSC) Trusts moved onto the system.

While performance dipped during this initial period — most notably for urgent breast cancer referrals — Mr Nesbitt said the figures should be viewed in context, stressing that reform was both necessary and overdue.

“While there is still more to do, the progress since then shows that reform was necessary, that it was the right decision, and that it is already delivering results.”

Early disruption during transition period

The statistics show that just 6.8% of urgent breast cancer patients were seen within the 14-day target during the quarter, a figure Mr Nesbitt said reflected short-term disruption as the regional service was introduced.

He noted that the 14-day breast target “has never been consistently met in Northern Ireland” and that performance had already been deteriorating prior to reform.

“Without intervention, the service was becoming less equitable and less sustainable.”

The move to a regional booking system was designed to tackle what the Minister described as an unacceptable “postcode lottery” in access to care.

“Previously, the likelihood of being seen within 14 days depended on where you lived. Before reform, one Trust was achieving 92.9% while another was at 3.8%. That postcode lottery was not acceptable and it was not equitable.”

Under the new model, patients are offered the earliest available appointment anywhere in Northern Ireland, rather than being limited to their local Trust.

Improvements since September

Mr Nesbitt pointed to significant progress since the end of the reporting period, including the introduction of a regional waiting list initiative in October to fund additional evening and weekend clinics.

Between October and December, 928 extra red-flag appointments were delivered, reducing the regional breast assessment waiting list from 12 weeks in September to just over seven weeks by mid-December.

“Whilst I absolutely acknowledge that too many women are still waiting for too long, I want to reassure the public that the latest position is much improved compared to where it was last year.”

Further clinics have already been delivered this month to offset a brief reduction in capacity over the Christmas period, with the Minister saying he expects average waiting times to continue to fall.

Workforce pressures and digital change

A review of breast services identified a structural shortfall of around 3,900 patients per year, driven by rising referrals and workforce pressures, particularly in radiology.

“No Trust could meet demand on its own. Regional working allows capacity to be pooled and investment targeted where it makes the most difference.”

The Department of Health is now working with NHS Scotland to implement a modern consultant-led model supported by a broader skill mix, backed by £5 million in recurrent funding.

The Minister also acknowledged that both 14-day and 62-day targets dipped during the transition, partly due to the roll-out of the encompass electronic patient record system across Trusts.

“These were expected short-term effects. The benefits of reform are long-term.”

Latest cancer waiting time figures

The Department of Health published Accredited Official Statistics covering July, August and September 2025, offering a snapshot of cancer service performance across Northern Ireland.

Key figures include:

• 31-day target (decision to treat):

  
  

  2,841 patients began treatment, with 88.0% starting within 31 days — a slight improvement on the previous quarter.

• 62-day target (urgent GP referral):

  
  

  1,430 patients started treatment, with 30.1% seen within 62 days, down from 32.5% in the previous quarter despite an increase in overall patient numbers.

• 14-day breast target:

  
  

  2,699 patients were first seen following an urgent referral, with 6.8% meeting the 14-day standard — the first full quarter of all five Trusts reporting under the new regional system.

• Breast cancer referrals:

  
  

  6,194 referrals were received during the quarter, 85.7% of which were classified as urgent.

The Department cautioned that data sourced from the encompass system are classed as “official statistics in development” and are not directly comparable with legacy data, though they are considered robust enough for publication.

Focus on long-term improvement

Mr Nesbitt said improving cancer performance remains a top priority, supported by investment through the Elective Care Framework, expansion of Rapid Diagnosis Centres, increased imaging capacity and targeted insourcing, including support from NHS Forth Valley.

“I recognise the anxiety that delays cause for patients and families. While today’s figures cover an early transitional period, the progress since then shows that reform was necessary.”