Review finds breast cancer 'weaknesses over years'

The County Durham and Darlington NHS Foundation Trust has apologised to impacted patients

An independent review has found "escalating concerns" about the breast cancer care service provided by an NHS trust.

The review, commissioned by the County Durham and Darlington NHS Trust in March, found "clinical failures in the Breast Surgery Service", according to a report released this week by independent governance advisor Mary Aubrey.

The review also found "weaknesses in leadership, clinical governance, organisational culture and contract management over many years".

Chief executive Steve Russell apologised to the patients affected and said: "You put your trust in us and in some cases that trust was not met. We didn't offer the high quality care you needed and deserved."

He acknowledged that the findings of the review would "dent" confidence.

In July this year, a separate review by the Royal College of Surgeons (RCS) of the trust's breast care services found 12 patients had been contacted to discuss care which led to harm, with some women receiving "more extensive surgery than was clinically necessary at the time".

The RCS also found cancers that were missed, mastectomies that may not have been necessary and surgery undertaken to remove lymph nodes when not clinically necessary.

The trust's board met to discuss the findings of the latest review

In documents published ahead of an earlier meeting, the trust's board said the most recent review was commissioned after an incident with a patient "concerning a delayed cancer diagnosis following fine needle aspiration".

The review also found what Ms Aubrey referred to as an overall "passive assurance culture", which meant the board failed "in challenging or scrutinising the Executive Directors when concerns were raised" which "further enabled unsafe practices to continue unchecked".

Ms Aubrey also found staff "experienced deterrents to speaking up" and that "concerns raised were not consistently listened to, acted upon, or escalated".

Potentially thousands affected

In response to the review, the board approved an "action plan" which included "stronger leadership at speciality and divisional level" and "stronger medical leadership and accountability".

The board said only "specialist registered clinicians" would now be placed in consultant roles, two new breast consultant surgeons have been appointed and investment has been made in modern equipment

More than 200 cases of patients who had problems with the service have been been identified so far, but the trust said there could be thousands of cases dating back to 2019, mainly at the University Hospital of North Durham.

A number of patient deaths were also being investigated, the trust said.

It said it had received over 270 calls to a contact line set up for patients with concerns.