The Royal College of Radiologists has been called into examine ‘very serious failings’
University Hospital of North Durham(Image: Craig Connor/ChronicleLive)
After “very serious failures”, there will be a second major external review into breast cancer services at the County Durham and Darlington NHS Trust. Issues at the hospital trust saw some women experience missed diagnoses and even unnecessary surgery. Now, the Royal College of Radiologists is to look into how tools such as X-rays and mammograms have been used.
The NHS trust – which runs services at University Hospital of North Durham and Darlington Memorial Hospital – has already seen an investigation led by the Royal College of Surgeons this year, which exposed cases where some women may have underwent mastectomies that weren’t clinically necessary.
Last week, the hospital trust formally apologised to patients. Trust executive Kathryn Burn said the organisation was “truly sorry” and that it was working to improve at pace. Two new consultant surgeons have already been appointed – while a hotline for those who have concerns about their care has been established.
Now at a meeting of the North East and North Cumbria’s Integrated Care Board (ICB) – the NHS organisation which commissions health services in our region – it has been revealed that a second Royal College is to examine the situation. At the meeting this week, ICB executive medical director Dr Neil O’Brien said: “I first want to absolutely recognize the distress and worry this will and may cause members of the public.
“Any individual who goes through a cancer journey has to have absolute confidence in the services that are provided by the NHS – and in the vast majority of cases and times, the NHS performs well. Unfortunately, in this case, CDDFT has recognized that the care patients received was not of the standard that it should have been and [the trust has] issued a public apology for that.”
The RCS found “outdated” treatment and cases where unnecessary surgery had taken place. In numerous cases, the wrong kind of biopsy – used to check if a tumour is cancerous – was undertaken. The ICB’s chair Prof Sir Liam Donaldson also struck a grave tone, highlighting that the problems had been “very serious” and pertained to “life and death matters”.
Our ChronicleLive Daily newsletter is free. You can sign up to receive it here. It will keep you up to date with all the latest breaking news and top stories from the North East.
NHS bosses also heard how an “idiosyncratic” arrangement had seen an outsourced contract to run breast imaging services in place which had seen some patients asked to attend appointments late into the evenings – even at 10pm. This arrangement was brought to an end earlier this year.
Dr O’Brien added that the previous review – instigated by the ICB following concerns about patient outcomes and from the Northern Cancer Alliance – had not been “specifically looking at the radiological practice within the service”.
Dr Neil O’Brien – chief medical officer at the North East and North Cumbria Integrated Care Board(Image: NHC NENC ICB)
Dr O’Brien said: “We think it is prudent to actually commission a Royal College of Radiologists review into the breast services into CDDFT. We’re in the process of establishing the terms of reference of that. This work though will take a number of months to conclude.
“We’re not waiting for that report to make sure that patients are kept safe. So we’ve instituted some immediate safety mitigations such as double reporting of X-rays and mammograms whilst we’re doing this work.”
A “look-back” exercise is ongoing and has seen the care of almost 200 women examined thus far. Dr O’Brien said: “We are committed to going back and looking at every single woman who may well have been affected by this and ensuring that any treatment deficiencies are corrected.”
The ICB’s chair Prof Sir Liam Donaldson, formerly England’s chief medical officer, added: “We should not be in any doubt that this is a very serious failure in standards of care in a crucial area of service that has survival and life and death matters involved. So it does need to be looked at extremely carefully.
“The initial investigations have uncovered a lot of the reasons that this happened, but there are further investigations pending and we need to make sure that those are done as thoroughly and independently as possible.”
Last week, Kathryn Burn, the County Durham and Darlington NHS trust’s executive director of nursing, said: “We know that some patients have not received the standard of care that we would want for them, or that they deserve. We have identified areas where improvement was needed – including how surgical decisions were made, how our multidisciplinary teams (MDTs) worked and where some outdated practices were still in use.
“For some patients, this may have resulted in more extensive surgery than was clinically necessary at the time. We fully recognise how distressing this is to hear, and we are truly sorry.
“Over the past four months, we have been reviewing the care of patients who had surgery through the breast service in 2024. Where we have concerns about the care a patient received we are contacting them directly and personally about this. Patients whose care has been reviewed and found to be appropriate are also being contacted to provide reassurance.
This work is not yet complete, and we continue to review patient notes. We have also set up a patient helpline and email address where any patients who have questions or concerns about their care can get in touch with us to share their experience.”
The helpline is available at 0191 3332126 while patients can also make enquiries or provide feedback using the email address cddft.breastservices@nhs.net.
ChronicleLive has created a dedicated WhatsApp community for breaking news and our biggest stories. You can join this WhatsApp community here. It will keep you up-to-date with news as it breaks and our top stories of the day sent directly to your phone.