Debate contribution: Mental Health Data

Debate contribution by Mr Mike Nesbitt on 16 February 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

16 February 2026

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Mental Health Data

Assembly identifier

Official Report component 5392034

Read the official Assembly record

Text

Deputy Speaker, thank you. I thank the sponsors of the motion. Data has to be the fundamental foundation if we are going to deliver consistent, standardised, regional services. It is the key to planning best services, targeting resources, monitoring safety, measuring outcomes and learning what truly helps. Without it, there is a real risk that people will design services for the benefit of the system rather than for the benefit of the individuals. That simply cannot stand. Let me be candid about where we are today. Trust-level information is drawn, as Members noted, from the new Encompass workflows. I think that Members were expressing frustration that Encompass is taking a long time to bed in and move to truly validated statistical reporting. In parallel with that, the Public Health Agency receives quarterly aggregated returns from the community and voluntary sector on mental health, addictions and suicide prevention services. Those are really useful for understanding demand, waiting times and indicative outcomes, but they are not patient-level datasets, so it cannot yet unlock fully standardised pathway-level analysis right across the region. Alongside those resources, we use some specialist datasets, including annual suicide stats from the Northern Ireland Statistics and Research Agency (NISRA) and PSNI stats on sudden death notifications to support real-time surveillance. Mr McGrath mentioned the PSNI. Of course, as it moves to Right Care, Right Person, it will not deal as often with patients with mental health issues, and the reporting of data may, correspondingly, decline. There is also the self-harm registry, covering ED attendances for self-harm and suicidal ideation, and the substance misuse database and impact measurement tool for addiction-related monitoring. Each adds value. None on its own provides the complete, integrated picture that clinicians, planners and the public deserve and that Members have, rightly, called for. During the roll-out of Encompass, temporary discrepancies have arisen, as historical data is cleansed, workflows are aligned and staff are retrained. That is normal in a transformation of that scale. Some trusts have, understandably, reported lower confidence in certain waiting-time and activity metrics during the early phase. That is why governance has been strengthened and validation has been intensified while we stabilise the new reporting logic. As Members noted, the Public Accounts Committee has been forthright about the historical quality of mental health data and the need for urgent improvement. I welcome that scrutiny. It helps to focus attention on what matters: consistent activity measures; clinically meaningful outcomes; and transparency so that the public can see what is improving and where there is still work to do. Public confidence is key here. The Department's responses make it clear that a single, standardised dataset and regular public reporting are the direction of travel. The PAC's specific expectations also align with our priorities, which are to use outcomes in order to improve services; benchmark consistently across the trusts; and publish mental health data regularly, once validated. It is not about creating league tables; it is about creating a shared language that reflects quality, safety and effectiveness, which, in turn, helps teams to learn from one other and helps us to see where to invest for the greatest impact. The cornerstone of improvement is, as I said, Encompass: our unified, electronic health and care record. Its region-wide roll-out concluded on 8 May 2025. We are now in a structured two-year stabilisation and optimisation phase. Again, I recognise that Members may think that two years is a long time. I am not a techie: I think that it is a long time. Encompass replaces dozens of legacy systems with consistent, coded workflows across mental health, CAMHS, addictions, crisis and dementia services. As it matures, Encompass will provide real-time, comparable regional data for planning, public reporting and accountability. It is the biggest digital modernisation that our Health and Social Care system has undertaken ever, because it covers both health and social care, and it has been incredibly ambitious. Kate Nicholl mentioned the fact that no system can operate effectively if we do not have the proper use of secondary data. Yes, we need to correct an error from previous legislation. It remains my intention to introduce legislation on secondary data and have it passed into law in this mandate. To turn a single record into meaningful data, we need a single set of rules. The regional reporting group, which was established in 2024, brings together all five geographic trusts, the strategic planning and performance group (SPPG), Digital Health and Care NI and Encompass reporting specialists to standardise definitions, align workflows and test report logic.

Task and finish groups are fixing the hard problems, such as waiting-time definitions, post-discharge follow-up, referral routing, activity reporting and bed occupancy. That is the patient, detailed work that translates an IT platform into a repository for reliable and comparable statistics.

I am particularly pleased that, as is envisaged under the mental health strategy, a mental health outcomes framework not only has been developed but is being embedded in Encompass. The framework focuses on three linked questions, which concern quantity, quality and effect: how much did we do, how well did we do it, and is anybody better off? Those measures bring together activity, experience and clinical impact in a way in which clinicians recognise and service users value. Implementing outcomes measurement is a long-term commitment that requires engagement, training and practice development but that also enables teams to see improvement, reduce variation and address long waits in a disciplined way. A key objective has also been to understand our waiting times. Epic Systems/Encompass reports are now being used to extract monthly mental health waiting-time data in line with system oversight measures (SOMs), with each trust validating its figures against regionally agreed definitions and deadlines. It is, by design, management information during that validation period, but the direction of travel is the right one. One of the clearest lessons learned in the past two years is that referral quality matters. The CAMHS referral audit identified duplication, incomplete clinical information and inconsistent thresholds right across the trusts. Those are not just abstract issues. Rather, they affect children and families who are waiting for help. The audit is now being used to standardise pathways, improve coding and target training for referrers so that referrals are timely, complete and clinically appropriate right from the outset. Those are practical, front-line improvements that will make a difference to access and to patient experience. A range of improvements will be made in the near future, including, for example, validated waiting-time reporting. Each trust is validating mental health waiting-time data, which is extracted from Encompass and aligned with SOM definitions and timelines. As confidence rises, we will transition from internal management information to regular public reporting that is comparable across the region. Another example is the filling of legacy gaps. Report logic is being developed in Encompass with the SPPG and the trusts to address historical gaps in demand and capacity indicators: for example, for referrals and activity in non-inpatient services. Once that report logic has been developed, the indicators will go through extensive validation before being used in decisions and in public reports. Furthermore, pathway-level outcomes will be addressed. With the mental health outcomes framework embedded, teams will have a clearer view of activity, of experience and of clinical change for service users. That will support better triage, more timely psychological therapies and better insight into what works for whom. Members rightly ask why we do not publish everything now. The answer is straightforward, and it is that publication confers public authority, and with that must come public trust. Publication must be based on validated data that is consistent across the trusts and correctly interpreted. During stabilisation, we are deliberately treating Encompass outputs as management information while we complete validation and align workflows. It is not about hiding. Rather, it is about ensuring that what we publish is reliable and does not mislead service users or policymakers.

Once validated milestones are met, routine publication will follow, and the system will be better for it. I will give way to the Member.

As I said earlier, Epic Systems wants a two-year timeline from final implementation. The final two trusts came on board on 8 May 2025. Again, I have asked colleagues who work in digital why it will take so long to get to that point. I was at an internal conference not that long ago at which somebody made the point that Encompass is like something that we have designed to take us to the moon but that, at the moment, we are using only for a short break in Spain. That is probably unfair, but it is a pretty solid and memorable point to make. There is a lot more that Encompass can do. Like you, I am eager to see us get there sooner with it than we plan to.

Having said all that, I pay tribute to the people who are making this happen: the front-line clinicians and the teams who are adapting to new workflows and coding standards while continuing, under real pressure, to deliver care to people. Trust informatics staff, SPPG analysts and Encompass specialists who are working together to reconcile definitions, to fix report logic and to test outputs trust by trust have my thanks. I also thank community and voluntary partners, who provide essential therapies and supports and submit returns that inform the regional picture, and public health and statistics colleagues, especially in NISRA, whose careful stewardship of suicide statistics ensures the highest standards for a uniquely sensitive dataset. Their work is meticulous. It is not always visible, but it is essential, and I acknowledge it publicly.

OK.

Yes, I believe that the work is forward-looking. If you were to visit the digital care unit in Linenhall Street, you would see big screens full of data. I do not understand it — it is just numbers and letters — but the unit is able to identify, for example, a pattern in the greater Ballymena area with regard to a certain condition. Over time, the real value of Encompass, Epic and all the digital stuff will be in public health initiatives: understanding where patterns are emerging and making early interventions. When will that happen? For my money, I say that it will happen as soon as possible, but it is starting to happen. I have seen the unit at work, and it is impressive. I do not know whether the Health Committee has considered paying it a visit, but it might want to do so. The mental health strategy promised transformation, but transformation without measurement is just an aspiration, is it not? It is not an accountable way to go forward. We want better targeting, on the basis of knowing where waits are longest and outcomes are weakest, so that we can direct our therapies, our crisis response and our specialist capacity to where they will have the most impact. We want earlier intervention. Consistent referral and triage data allows us to see where early intervention helps services reduce pressures and to scale those models. We need workforce planning. Standardised activity and outcome data inform skills mix and training needs across the trusts and, indeed, our community partners. Finally, we need public accountability. As I said, regular and reliable publication of mental health data supports the strategy's promise of transparency and is not to point fingers but to build trust; you do that through an evidence base. I will close, as I began, with thanks and a commitment to partnership. To our staff, our community partners, our analysts and our statisticians, I say thank you for your patience and your persistence. To Members across the House, I say thank you for the scrutiny that keeps the Department focused. We are not where we want to be yet, but the path is clear: a unified record, standard definitions, validated reporting and outcomes that mean something to the people whom we serve, alongside publications that build public trust. That is how we will turn data into decisions, decisions into better outcomes and better outcomes into lives changed for the better.

2,015 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 14:56 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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