Women 'traumatised' by breast cancer treatment at NHS trust | BBC News

Key Concepts

• Durham and Darlington NHS Trust: The healthcare trust under investigation for breast cancer care.
• Patient Harm: The central issue, with over 200 patients identified as having been harmed, including 43 with significant harm.
• Missed Cancers: A critical failure where cancerous growths were not detected.
• Unnecessary Mastectomies: Surgical removal of the breast that may not have been required.
• Delayed Diagnosis: Significant delays in identifying breast cancer, impacting treatment outcomes.
• Outdated Diagnostic Tests: The use of older technology that contributed to diagnostic delays.
• Royal College of Surgeons Report: A formal review highlighting serious problems within the trust's breast cancer services.
• Northern Cancer Alliance Report: Another report that identified issues with the trust's care.
• Chief Executive Steve Russell: The new leader of the trust, who acknowledged past failures and committed to change.
• Conflict of Interest: Allegations and admissions by the trust regarding potential conflicts involving a lead breast surgeon running private clinics.
• Per-Patient Payment Model: The payment structure for the lead surgeon's private clinics, raising concerns about financial incentives.
• Lack of Compassion and Care: A recurring theme of poor patient experience and emotional distress.

Investigation into Durham and Darlington NHS Trust Breast Cancer Care

A BBC investigation has revealed significant failings in breast cancer care provided by the Durham and Darlington NHS Trust, impacting over 200 patients. The inquiry has uncovered instances of missed cancers, potentially unnecessary mastectomies, and substantial delays in diagnosis, leading to significant harm for 43 individuals. One death is also under examination in relation to these issues.

Patient Experiences and Diagnostic Failures

The case of Kate Driver, diagnosed at 29, exemplifies the problems. Her GP referred her for urgent investigation to an NHS two-tier breast clinic. However, the initial tests used were outdated, contributing to a two-month delay in her diagnosis. Driver described the experience as "100 times worse than it needed to be," citing the emotional toll of waiting, chasing appointments, and feeling uncared for. She eventually moved her care to another trust, describing it as a "lucky escape."

Scale of the Problem and Historical Warnings

The medical records of nearly 1,600 patients are currently being examined. To date, over 200 women have been identified as having suffered harm. This harm encompasses unnecessary mastectomies, missed cancers, and diagnostic delays. Crucially, the BBC has learned that serious problems within the trust's breast cancer services have been flagged for over a decade.

Trust's Response and Leadership Acknowledgment

Steve Russell, who became the trust's chief executive in September, acknowledged that had action been taken more swiftly, "women may not have come to the same degree of harm." He stated, "It is not good enough that we were too slow to act on the information that was there." Russell expressed determination to implement changes to prevent future occurrences and apologized for the distress, anger, and loss of trust experienced by patients. The trust has formally apologized to Kate Driver for the failures in her care.

Recurring Reports and Lack of Action

Health correspondent Sharon Barber highlighted that the issues at the trust are not new. Investigations and warnings have been ongoing since at least 2012. Multiple reports, including one from the Royal College of Surgeons earlier in the summer and a previous report in 2019, have detailed serious problems, such as high mastectomy rates and low breast reconstruction rates, alongside missed cancers. The core issue, as Barber noted, is that "the trust didn't act on that. They knew about it. They didn't act on that. They didn't do anything."

Trust Takeover and Conflict of Interest Allegations

In response to the ongoing issues, the trust has undergone significant changes. A number of senior managers and clinical leaders have been replaced, and the operational model for breast cancer care has been dramatically altered. Furthermore, the investigation uncovered that the lead breast surgeon at the time was also contracted to run private out-of-hours clinics for the trust, with appointments sometimes extending to 11:30 p.m.

A significant finding was that this surgeon was paid on a per-patient or per-appointment basis. Freedom of Information requests revealed that companies associated with these clinics received nearly £6 million in the last six years alone. The trust has admitted to "conflict of interest elements" in this arrangement.

Impact on Patients and Emotional Distress

The consequences for affected women are profound. For those whose cancer was missed and has spread, or who underwent unnecessary mastectomies, the situation is often irreversible. Barber emphasized the trauma and devastation experienced by these women, noting that "if your cancer was missed and it spread or if you had a mistctomy that you didn't need, it's too late, isn't it?" Beyond the medical failures, many patients reported feeling devastated and angry due to a perceived lack of compassion and care from some staff members.

Conclusion and Future Outlook

The investigation into the Durham and Darlington NHS Trust's breast cancer care reveals a systemic failure to act on repeated warnings, leading to significant harm to hundreds of patients. While new leadership has acknowledged past shortcomings and initiated structural changes, the emotional and physical toll on affected women remains immense. The ongoing examination of patient records and the admission of conflicts of interest underscore the gravity of the situation and the long road to rebuilding trust.