'Reconstructive breast surgery wait just adds to the ordeal'

Christy Esslemont had a mastectomy in 2022

A breast cancer survivor has said a long wait for reconstruction surgery after a mastectomy is stopping her moving forward with her life.

Mother-of-one Christy Esslemont, 46, of Aberdeen, had a mastectomy in 2022 after being diagnosed with breast cancer, but fears still having to wait years for the follow-up reconstruction amid waiting list delays.

NHS Grampian currently has the longest waiting times in the country for plastic surgery, according to the latest figures.

Ms Esslemont said she had been left feeling "misled" and hurt by the uncertainty. NHS Grampian said it wanted to apologise publicly to everyone waiting too long for their reconstructive surgery.

The latest data shows that 43 people were waiting more than three years for plastic surgery with NHS Grampian - 16.3% of patients on the list, which was more than any other health board.

The second highest figure was NHS Tayside at 5.5% with 35 patients, with NHS Highland at 5.2% (four patients).

The Public Health Scotland figure for NHS Scotland as a whole was 1.3%.

'Long process'

After the single mastectomy in early 2022, Ms Esslemont underwent chemotherapy between September that year and January last year.

She then had radiotherapy over the following two months.

She said she now feared an uncertain wait for reconstructive surgery.

Ms Esslemont said she was in the process of lodging an official complaint to try and get answers for anyone in a similar position.

She told BBC Scotland News: "The surgery is just the final stage of this long process and it would just allow me to feel back to being me again, and to start afresh and feel that chapter is behind me and I can move forward."

Christy rang the "free from cancer" bell in 2023

"You put your life and your trust in the NHS and the surgeons," she said.

"I feel like I've kind of been misled. You know it's quite hurtful to lose that trust. It affects your self-esteem, your confidence in the way you look.

"Through the whole process you really feel very out of control of your life, of your body, of everything. This has just added another layer of this complete lack of control of my life and how I go forward.

"I really can't see how they can actually put a date on it because the list is just getting bigger and bigger and bigger. They don't know when they're going to start them up again. So how they can put a figure on it I don't know."

The issue was raised at Holyrood last week, where First Minister John Swinney apologised to those who had "waited too long" for reconstructive breast surgery.

It came after Conservative North East Scotland MSP Tess White highlighted the case of another woman who has waited for three years and still has not had her reconstruction.

Swinney pledged that Health Secretary Neil Gray would look into the issue.

NHS Grampian said in a statement: “We cannot comment on individual patient cases but would strongly encourage Ms Esslemont to contact us regarding any concerns.

“When a patient does make direct contact with us, we are more than willing to discuss their case with them - including their diagnosis, treatment and any further care they received.

“We absolutely acknowledge that a number of patients have waited vastly longer than we would have liked for their reconstructive surgery and the impact this has on their day-to-day lives. We’d like to take this opportunity to apologise publicly to each of them."

Additional funding

A spokesperson explained there are instances with breast cancer patients where, for clinical reasons, it is advised not to carry out breast reconstruction around the same time as a mastectomy.

“Unfortunately, our surgical capacity remains challenged. While these reconstruction surgeries are important and vital to the patients awaiting them, we need to prioritise patients based on immediate clinical need.

“Breast reconstruction operations usually take in excess of 12 hours to complete and require a large amount of staff and theatre provisions, which we are currently unable to provide due to a need to prioritise demand elsewhere."

The statement added: “We have been aware of the issues and challenges this creates for these patients for some time and recently contacted the Scottish government requesting either additional funding or the use of capacity elsewhere in Scotland, in the hope they can be seen sooner.”

The Scottish government said: "We have been engaging with NHS Grampian on this specific issue for some time and are determined to provide the necessary support to deliver improvements in this area.

“Breast reconstruction surgery includes some highly specialised complex surgeries which are only performed in few specialist centres around Scotland."

The statement added: “Currently plastic surgery services are concentrating efforts on treating patients with trauma or active cancers. Regrettably this means patients waiting for delayed reconstructive surgery are waiting longer for the care they need.”

Analysis by Susie Forrest, Health producer, BBC Scotland News

Plastic surgery includes all different kinds of operations to repair or reconstruct damaged tissue or skin, including after mastectomy for breast cancer.

These latest figures released by Public Health Scotland show patients in Grampian are facing longer waits than anywhere else to be treated by a plastic surgeon.

But the statistics also show that long waits are a much wider concern for NHS Grampian than just in this specialism.

There were a total of 663 patients under their care who had been waiting over three years for inpatient or day case treatment - three times as many as in Tayside, and over four times as many as in Greater Glasgow and Clyde.

If the Scottish government wants to fulfil its promise to eliminate the longest waits, effort will need to be targeted at the north east.