A private healthcare firm held contracts where there was not “robust” NHS oversight, a new report found.
University Hospital of North Durham(Image: Craig Connor/ChronicleLive)
A leading private healthcare firm said it is “supporting” a North East NHS Trust as it reviews hundreds of breast cancer patients after “very serious failings” in care were revealed. Spire Healthcare held an outsourced contract for breast cancer services – specifically diagnostic services.
Some surgical procedures took place under a different agreement, ChronicleLive understands, with decisions around the management of patients and any surgical procedures said to be managed by staff at the County Durham and Darlington NHS Trust. Breast cancer services at the trust have been heavily criticised in a series of reports this year, as previously reported.
In April, the NHS trust, announced a “probe” into its breast cancer services. This followed shocking external reports from groups including the Royal College of Surgeons which highlighted shortfalls in care.
In July, trust bosses made a public apology to patients and said it had been found that practices were “outdated”. “Very serious failings” were identified. These included that some patients had more extensive surgery than they’d have required, others were not offered a kind of chemotherapy drug they should have been, while some weren’t offered reconstructive breast surgery that they should have been.
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In a review of the trust’s governance in relation to breast cancer services published this week, independent expert Mary Aubrey highlighted once again how huge issues had been allowed to develop within the service over more than a decade. Ms Aubrey’s review looked at a period from 2012 to 2025 and found “early warnings” about these issues had been missed.
Ms Aubrey found “persistent governance failures”. And in the stark report, she also highlights “governance breakdown”, “failures of executive and clinical leadership” and “a persistent culture of silence and lack of psychological safety for staff” among a total of 12 structural issues which she says caused: “Avoidable patient harm, loss of public trust, regulatory and reputational risk, and financial loss.”
The report highlighted that “governance arrangements and contract documentation remained insufficient” while pointing to failures when it comes to the oversight of contracts with private medical providers including Spire Healthcare. Ms Aubrey’s said that one contract “was not subject to formal review or robust governance oversight, and remained largely informal, with gaps in assurance and accountability”.
One of the issues to come to light has been that some patients received surgeries they did not need. Some of these took places at Spire Healthcare – but it is understood that the management of patients remained the responsibility of NHS clinicians.
In the report, Ms Aubrey wrote: “Full‑day Saturday theatre sessions at Spire in 2017/2018 enabled high volumes of benign lesion excisions. The Trust provided patient lists in response to the numbers requested by Spire Healthcare Limited, but Spire undertook all scheduling of appointments on the theatre lists and within the one‑stop breast clinics.
“Many of these patients may not have needed surgery, and operating on benign breast lesions directly contributed to delays in the cancer treatment…”
A Spire Healthcare spokesperson said: “We note and are reviewing the Report of the Independent External Review of Governance within the Breast Service commissioned by County Durham & Darlington Foundation Trust.
“Spire is fully supporting the Trust’s on-going review of its NHS patients across all aspects of its breast cancer services. We are committed to working closely with the new executive team at County Durham & Darlington NHS Foundation Trust, to support patients and address any learnings.”
New County Durham and Darlington NHS Trust chief executive Steve Russell and interim chair of the board Alison Marshall apologised to patients after sharing the “deeply upsetting” report earlier this week. Mr Russell said: ““First and foremost, I want to say how deeply sorry we are.
“Reading this report and hearing the experiences of women and their families who were harmed has been profoundly upsetting. We failed to provide the standard of care our patients deserved, breached their trust, and for that, I offer my unreserved apology.
“Let us be clear – this is a turning point for our Trust. To our patients and our staff – we are determined that this is a moment to reset CDDFT and to rebuild from the ground up to make sure patients receive the safe, kind and high-quality care they should always expect from us. And whilst patients are our purpose, and always will be, our staff – no matter what role they have – are the key.”
Bosses said a “comprehensive action plan” had been implemented. This includes enacting the recommendations made in Ms Aubrey’s report. Further measures include improving corporate and clinical governance, “creating a safe and open culture where the voices of our staff are heard”, and improving the management of contracts.
Mr Russell added: “This is about ensuring that what happened here can never happen again and that it brings a cultural reset for the Trust. We will be open and transparent, we will listen, and, fundamentally, we will deliver the changes needed to make our services safer and stronger for the future for our communities.”
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