The running cost of encompass, Northern Ireland's Epic-based digital care record, has risen from an agreed £15m to £35m for 2026/27, Stormont's Health Committee heard, prompting Alliance MLA Danny Donnelly to say the project was "spiralling out of control". With spend already near £400m, the programme is a live public-sector project-management case study.
The figures were given at a Department of Health budget briefing to the Committee for Health, reported by The Irish News on 9 October 2026. The fullest independent account of the programme's history is Case Study 1 in the Northern Ireland Audit Office report Major IT projects in Northern Ireland (4 July 2025), followed by the Assembly Public Accounts Committee's report of 7 July 2026.
- Running cost: the 2026/27 figure agreed at £15m is now £35m, attributed by the Department to software licences and staffing (Irish News, 9 October 2026).
- Whole-life cost: £982.5m at Outline Business Case, £1.61bn at Full Business Case (December 2019), £1.95bn after a 2022 addendum and £1.99bn according to the PAC in July 2026.
- Implementation spend: £343.6m capital plus £56.2m revenue, £399.8m in total, to March 2026 (Assembly answer reported 22 April 2026).
- Procurement: one of two final bidders withdrew in February 2019, leaving a sole supplier; the contract was signed on a time-and-materials basis.
- Go-live: all five trusts were live by 8 May 2025, between 13 and 20 months later than planned.
1. What encompass is
encompass is a single digital integrated care record for Health and Social Care (HSC) in Northern Ireland, built on software from the US supplier Epic. It was planned to replace about 70 legacy systems, a scope the NIAO says was later reduced to 45 main systems. Patients access their records through the My Care portal, which passed 100,000 active users on 14 March 2025, covering the South Eastern, Belfast and Northern Trust areas (DHCNI). GPs, who are independent contractors, have read-only access through EpicCare Link rather than working inside the system.
2. Conception and business cases
According to the NIAO, pre-procurement began in early 2015 and a Strategic Outline Case was compiled in December 2015. The Outline Business Case (OBC) was submitted in 2017 and approved in May 2018, with a whole-life cost of £982.5m. A Procurement Strategy followed in November 2017.
The Full Business Case (FBC) went to the Department of Finance in December 2019 at £1.61bn for 2019-20 to 2030-31, 64% higher than the OBC. In late 2020, after the contract was signed, the Business Services Organisation (BSO) found that the FBC had significantly underestimated costs. An FBC Addendum in November 2022, approved by the Department of Finance in December 2022, added £334.4m (20.7%), taking the estimate to £1.95bn.
The NIAO also recorded a scope gap: "The encompass Business Case did not include data archiving." A data archiving programme of about £10m, not in the original business case, has since been added.
3. Procurement: from twelve bidders to one
In August 2018 the BSO shortlisted four of twelve bidders, intending to take only two to the final stage. On 25 February 2019 the bidder the NIAO calls "Supplier B" withdrew, leaving a sole supplier. The NIAO's judgement: "Supplier B's withdrawal ultimately removed competitive tension from the process." The NIAO refers to Epic only as "Supplier A"; other bidders are not named publicly.
The contract type changed too. The BSO had originally sought a fixed implementation price, but the contract was signed in May 2020 on a time-and-materials basis, and the BSO did not ask for a fixed-price quote to compare, the NIAO found.
The award was announced on 10 June 2020 by then Health Minister Robin Swann as "£300m over 10 years", covering the contract plus ICT infrastructure, with more than 200 HSC jobs (Department of Health). The contract value itself differs by source: The Register reported £273.4m, citing tender notice 280672-2020, for 10 years with an optional five; HTN and Digital Health reported £275m.
4. Cost history: two different measures
Two separate series exist and must not be mixed: the whole-life programme cost used by the NIAO and the PAC, and implementation spend quoted by the Department of Health and the press.
Whole-life programme cost
| Date | Figure | Basis | Source |
|---|---|---|---|
| 2017 (approved May 2018) | £982.5m | Outline Business Case | NIAO |
| December 2019 | £1.61bn | Full Business Case, 2019-20 to 2030-31 (+64%) | NIAO |
| November/December 2022 | £1.95bn | FBC Addendum, +£334.4m (+20.7%) | NIAO |
| March 2025 data (published July 2025) | £1.93bn | Latest estimate, £947.5m above the OBC; RAG status "Green" | NIAO |
| July 2026 | £1.99bn | "Current estimated cost" (basis not stated) | PAC |
Implementation spend and headline figures
| Date | Figure | What it measures | Source |
|---|---|---|---|
| June 2020 | £300m over 10 years | Contract plus ICT infrastructure | Department of Health |
| October 2022 | £450m | "Investment in future patient services" (Programme Director job advert) | NI Chamber |
| November 2023 | About £300m | Implementation-phase capital over 10 years | DHCNI FAQ, via Irish News |
| June 2025 | About £326m spent | £292.6m capital plus £33m revenue, spend to date | Department of Health, via Irish News |
| June 2025 | £360m | Predicted final implementation cost (forecast) | Mike Nesbitt, via Irish News |
| To March 2026 | £399.8m | £343.6m capital plus £56.2m revenue, actual spend | Assembly answer, via Irish News (22 April 2026) |
| April 2026 | £238m | Projected costs over future years | Assembly answer, via Irish News |
Two cautions apply. First, the £360m of June 2025 was a forecast of final implementation cost, while the £399.8m of April 2026 is actual spend to date including revenue, so the two are not like-for-like. Second, an Irish News headline of 22 April 2026 described the system as "£100m over budget" by setting the £399.8m against the original £300m. That £300m was described as capital, while the £399.8m includes £56.2m of revenue; MLA Diane Forsythe, who tabled the question, compared capital only: "nearly £350m (capital)" against £300m.
Running costs
In June 2025 the Department expected ongoing supplier costs of £11.5m a year once all trusts were live. The October 2026 briefing heard that the 2026/27 running cost agreed at £15m had risen to £35m. The increase was explained by server costs plus individual licences for each device; there are 115,000 licences for about 72,000 HSC staff, and the Department is reviewing which staff need which packages. Microsoft licences were originally £70m (period not stated). No official breakdown of the £35m has been published. Separately, the NIAO noted legacy systems cost about £6.5m a year (an FBC figure), none had been switched off, and the costs of extending legacy contracts had not been collated.
5. Go-live: five trusts, four waves
The original plan, as announced in 2020, was for the South Eastern Trust to go live in 2022 and all trusts by the end of 2024; the NIAO dates the planned start of go-lives to April 2022. The programme board later decided to combine the Southern and Western go-lives.
| Trust | Actual go-live | Delay against plan (NIAO) |
|---|---|---|
| South Eastern | 9 November 2023 | 19 months late |
| Belfast | 6 June 2024 | 19 months late |
| Northern | 7 November 2024 | 18 months late |
| Southern | 8 May 2025 | 20 months late |
| Western | 8 May 2025 | 13 months late |
Sources: DHCNI encompass timeline, Department of Health (8 May 2025) and NIAO. The NIAO attributed the delays largely to COVID-19 and recruitment difficulties. Post-live optimisation runs from August 2025, 15 months later than planned, with implementation completion given as September 2027 by the NIAO and "2027/28" by DHCNI.
6. Problems since go-live
Statistics
The NIAO reported that NISRA has not endorsed encompass data, and key waiting-time and cancer statistics are labelled "official statistics in development", with no firm date for full publication. The PAC said "No clarity was provided as to how long the reporting issues will prevail", called it "not acceptable that these issues have been allowed to persist", and warned that poor trust performance could go unchallenged.
Missing referral letters
On 2 June 2026, around 12,000 pieces of correspondence were disclosed in the Assembly as having gone missing, after questions from Alliance MLA Stewart Dickson (Irish News/PA). Mr Nesbitt, then Health Minister, said: "There were failures within the process, and I accept that and apologise for it." Of the two fail-safes that did not work, he said "By definition they are not fail-safes", adding "No physical harm was done". On 29 June 2026 DUP MLA Paul Frew said: "I'm led to believe that it's just under 50,000 letters." Mr Nesbitt could not confirm that figure, citing duplication, and called the episode "a matter of deep regret for me" (LBC/PA).
Inappropriate access to records
The Irish News reported on 6 August 2026 more than 40 incidents of "inappropriate access to patient information". Belfast had the highest number (not given), Northern had 8, and South Eastern had 9 in 2024/25; in the Western Trust two met the threshold for referral to the Information Commissioner's Office. In a written answer, Mr Nesbitt said: "Not all such incidents meet the threshold for a notifiable UK GDPR breach."
Undelivered scope
The PAC lists core scope still to be delivered: Children's Social Care, replacement of the Child Health System, Screening and GP Out of Hours. The NIAO adds that prison healthcare has an uncertain timeframe. A Centralised Archiving Solution is targeted for December 2028 and formal decommissioning of legacy systems for March 2029.
7. Benefits claimed
In June 2025 Mr Nesbitt put cash-releasing benefits at £29.6m and non-cash-releasing benefits at £514m, called encompass "Europe's most comprehensive digital care record", and acknowledged: "Yes, £360m is a lot of money." The NIAO gives no benefits figures for encompass, and the PAC said data problems undermine "confidence in its reported benefits".
8. Governance
The Senior Responsible Owner is Dr Dermot Hughes, described by the Department as "HSCNI Senior Responsible Owner for encompass". The BSO ran the procurement and made the time-and-materials decision; the encompass programme board took delivery decisions such as combining the final go-lives; the Department of Finance approves business cases and the 10% cost tolerance; and Digital Health and Care NI (DHCNI), within the Department of Health, oversees the archiving programme.
Gateway review reports and programme board membership have not been published. The only rating found is the NIAO's note that the latest highlight report was RAG "Green". At the October 2026 briefing, the Department's Investment Director Paul Montgomery said: "I cannot speak for the encompass team, it is a pressure that has just been identified to us," and "I am content that we are making an adequate level of challenge."
9. Project-management lessons from the audit findings
The points below are our analysis of the NIAO and PAC findings, not new facts.
- Protect competition to the end. Shortlisting only two finalists meant one withdrawal left a sole bidder.
- Match contract type to risk appetite. Moving from a sought fixed price to time-and-materials, without a fixed-price quote to compare, left the public buyer exposed to overruns.
- Get the estimate right before signing. The whole-life cost rose 64% between OBC and FBC, then a further 20.7% after the contract was signed. The NIAO calls for realistic cost and time estimates before contract signature.
- Understand what is being replaced. Archiving was left out of the business case, legacy systems kept running, and extension costs were not collated. Across NI's major IT projects, Comptroller and Auditor General Dorinnia Carville called extending legacy contracts "very poor value for money".
- Price licences and running costs at real scale. The 2026/27 running cost rose from £15m to £35m, with 115,000 licences for about 72,000 staff, a pressure the Department's official said had "just been identified".
- Build in data and reporting continuity. Losing endorsed waiting-time statistics weakens accountability and, as the PAC notes, confidence in reported benefits.
- Resource the team. The NIAO stresses the right skills on project teams; recruitment difficulties were a stated cause of delay.
The Republic of Ireland is now starting the same journey. The HSE launched procurement for its national One Health Record on 13 March 2026, with rollout planned from 2029 to 2032 (HSE); no official cost has been published.
10. Frequently Asked Questions (FAQ)
Q: How much has encompass cost so far?
A: Installation and implementation spend to March 2026 was £399.8m (£343.6m capital plus £56.2m revenue), according to an Assembly answer reported in April 2026. The whole-life programme cost, a different measure, was put at £1.99bn by the PAC in July 2026.
Q: Why did the running cost rise to £35m?
A: The Department of Health attributed the increase from £15m to software licences and staffing, including server costs and per-device licences. No official breakdown has been published.
Q: Was the Epic contract competitively tendered?
A: Twelve bidders entered and four were shortlisted, but one of the two final bidders withdrew in February 2019. The NIAO said this "removed competitive tension from the process".
Q: How many referral letters went missing?
A: About 12,000, according to figures given in the Assembly on 2 June 2026. An MLA later claimed "just under 50,000", which the then Health Minister could not confirm.
Conclusion and Outlook
encompass is now live across Northern Ireland, and the Department claims large non-cash benefits. Yet the audit record shows a programme whose whole-life cost doubled from its first business case, procured without final-stage competition on a contract that left cost risk with the public sector, and still carrying legacy systems, archiving work and undelivered scope towards 2029. The £20m running-cost pressure is the latest sign that full costs were not understood at the outset. The next tests are the Department's licence review, implementation completion in 2027, and whether NISRA can restore endorsed waiting-time statistics.
Sources: The Irish News (Allan Preston, 9 October 2026; 22 April 2026; 19 June 2025; 15 November 2023; Paul Ainsworth, 6 August 2026); Irish News/PA (Bairbre Holmes, 2 June 2026); LBC/PA (29 June 2026); NIAO, Major IT projects in Northern Ireland (4 July 2025); NI Assembly Public Accounts Committee report and press release (7 July 2026); Department of Health NI releases (10 June 2020, 3 October 2023, 8 May 2025); DHCNI encompass timeline (updated 8 May 2025) and My Care release (14 March 2025); The Register (Lindsay Clark, 17 June 2020); HTN (11 June 2020); NI Chamber (11 October 2022); HSE (13 March 2026).
Cover image: AI-generated illustration of a hospital ward; it does not show an encompass screen or any real hospital.
