To ask the Minister of Health to detail any processes in place to ensure that the downgrading of an urgent referral, including for suspected cancer, to a routine non-urgent referral does not lead to delays in diagnosis or treatment.

The triage of referrals, is a clinically led process undertaken in accordance with regional referral guidance, national clinical guidelines and professional standards.

The Northern Ireland Referral Guidance for Suspected Cancer (Red Flag Criteria) draws on national evidence, including NICE NG12, alongside local clinical expertise to provide clinicians with standardised, evidence-based criteria that support consistent decision making for red flag referrals.

All referrals are triaged by clinicians to determine whether the information provided by the referrer supports the level of urgency requested. Where, following clinical review, a referral is downgraded to urgent or routine, this is based on clinical judgement within established referral guidance.

Referring clinicians retain the ability to rerefer or seek urgent reassessment where there are concerns regarding deterioration or the development of new symptoms. Escalation processes are also in place to review a patient’s priority where additional clinical information becomes available or a patient’s condition changes.

As outlined in the Integrated Elective Access Protocol (IEAP), following the receipt and triage of a referral, the patient is sent an acknowledgement letter or text that confirms receipt of the referral, the name of the specialty the patient has been referred to, the clinical urgency assigned by the clinician at triage and contact details for the relevant service. Trusts continue to keep communication arrangements under review to ensure patients are appropriately informed about their care.

While no maximum timeframe is specifically set for the review of referrals that have been downgraded to urgent or routine, patients are managed in line with regional waiting time standards relevant to their urgency. Performance against waiting time standards is monitored at a Trust and regional level.

My Department works with Trusts to promote the consistent application of referral guidance and to support ongoing improvement in referral pathways, including those for suspected cancer.