Cancer waiting times are a challenge across every health system, and Northern Ireland is no exception. Long waits can increase clinical risk for some patients and place additional strain on staff who are already working under significant pressure. It is also recognised how hard teams are working, often in difficult circumstances, to deliver safe and timely care.
However, the current situation in Northern Ireland required urgent attention. As reported in response to a question tabled at the Northern Ireland Assembly on 12th November 2025, Mr Philip McGuigan MLA responded with data that showed the median wait time for cancer treatment from referral across all Tumour sites has increased year-on-year by 7.8%. Since June 2019, this is equivalent to a 3-day delay every year across all Tumour sites.
Cancer Research UK (CRUK) remain committed to supporting practical, locally led action that helps protect patient outcomes and strengthens cancer pathways. In response to this situation, CRUK sponsored a short, time-limited piece of work from MBI. The purpose was simple: to listen, to learn, and to help create the conditions for practical action that protects patient outcomes.
This programme was designed to support the people delivering care by listening to experiences across the system and help identify practical opportunities to improve cancer pathways. The intention was not to assess performance, but to understand the reality on the ground.
Over an intensive period, MBI gathered a range of perspectives and insights from people working across cancer services, including clinicians, operational managers and system leaders. The organisations represented from this stakeholder engagement include:
- Northern Trust
- Southern Trust
- South Eastern Trust
- Belfast Trust
- Western Trust
- Northern Ireland Cancer Network
- Department of Health
- Queens University Belfast
This was an opportunity for those involved to share what it is really like to manage cancer pathways day to day, what helps things work well, and where there are barriers or risks.
The outcome of this work was a report setting out a practical route to achieving cancer services recovery in Northern Ireland, grounded in frontline insight, existing good practice, and a clear understanding of the system’s current constraints and opportunities.
The reporting delivered 15 short- and medium-term recommendations focused on:
- Aligning Leadership and Governance with delivery
- Demand and referral management
- Service capacity and workforce
- Restoring operational grip and visibility
- Reducing variation and pathway inconsistency
- Supporting a culture and readiness for change
The report reflected that there was already broad agreement on what needs to change across Northern Ireland. The principal issue was ensuring agreed changes were implemented consistently, across the whole system, and with clear accountability for delivery.
The report acknowledges there was no single root cause. Performance was being constrained by a combination of factors: rising demand, diagnostic bottlenecks, workforce pressures, variation in pathways, and a loss of operational grip following the implementation of Encompass. However, none of these challenges are unique, and in many cases, solutions already exist within the system itself.
“MBI Health’s experience supporting organisations to improve cancer waiting times, combined with extensive operational leadership expertise, brought valuable insight to our work in Northern Ireland.
Their ability to work collaboratively with clinical and operational stakeholders resulted in a report that inspired confidence among those involved and across the system.”
Naser Turabi, Director of Health Policy and Evidence, Cancer Research UK
The report findings were shared and acknowledged at the Northern Ireland Cancer Strategy Advisory Forum and shape the ongoing dialogue between CRUK and the Department of Health in Northern Ireland around recovering cancer waiting times.
You can access the full report here.
