Breast cancer assessment appointments are to be offered in fewer hospitals in Northern Ireland under proposals to consolidate services and reduce waiting times.
The Department of Health is planning to focus services on three sites – in greater Belfast, Londonderry and Antrim.
Patients are referred for breast assessment appointments on the basis of mammogram results or physical symptoms identified by clinicians.
Current breast screening arrangements in Northern Ireland will not be impacted by the proposals.
Assessment services for symptomatic referrals are currently provided at Altnagelvin Hospital in Derry, Antrim Area Hospital, Craigavon Area Hospital, Belfast City Hospital and the Ulster Hospital.
Assessments following breast screening tests are provided at four locations – Altnagelvin, Antrim, Craigavon and a facility at Linenhall Street in Belfast.
Under the proposals, all assessments will be consolidated at three sites – Altnagelvin, Antrim Area and a Belfast facility, most likely the Ulster Hospital.
Health officials believe waiting times will worsen if action is not taken, with the current model of smaller units covered by a stretched workforce more susceptible to service disruptions.
The proposals have now gone out for a 12-week public consultation.
The Department of Health has also undertaken an urgent review of breast surgery service in the region, with a report due by the end of the year.
Richard Pengelly, Department of Health Permanent Secretary, said: “We have listened carefully to patient voices and it is very clear that timely access to care is the overriding priority.
“The way breast assessment services are currently delivered is becoming increasingly fragile.
“Staffing challenges are an important factor behind these pressures and demand for care – including urgent referrals for suspected cancer – is increasing.
“Sticking with the current model would mean ongoing and worsening vulnerability, with deteriorating waiting times for assessment. That would simply be unacceptable.
“Consolidating care on three sites means we can provide durable and quality services, for the benefit of patients and staff.”
The proposed reforms include a new centralised appointment booking system.
The department also plans to establish a regional Breast Assessment Network to shape and support service provision for the future.