During an extraordinary meeting on Thursday (September 24) the trust’s board backed plans to complete its current review of cases from January 2023 to February 2025 before working backwards towards 2015, one year at a time.
Experts will assess the findings from each year before deciding whether the review needs to go back further.
County Durham and Darlington NHS Foundation Trust
The decision follows mounting evidence that concerns about breast cancer services had been raised for more than a decade before the current scandal emerged.
Alison Marshall, chair of the board, issued a fresh apology to patients and families during the meeting at Prospect House in Durham, saying: “We are sincerely sorry for the harm caused to patients and families across the region.
“We can’t turn the clock back as much as we want to do, so we’re trying to be as open and transparent to patients and the public”
Chief executive of the Trust, Steve Russell added: “Patients were failed by us and no decision or ruling can ever change that. We can work with women and care boards to make sure their care is investigated and looked into in depth
Of 514 cases reviewed so far, 315 patients were found to have suffered harm, including 77 who suffered significant harm.
At least 20 women have been identified as having undergone unnecessary mastectomies, while other cases involved delayed or missed cancer diagnoses and unnecessarily extensive surgery.
One patient is known to have died.
University Hospital of North Durham in Durham City
Board members acknowledged that there are “likely more cases of harm” outside the period currently under review.
The trust has also accepted there were opportunities to act sooner.
During the meeting, non-executive board member Phil Kane expressed his concerns about contacting women about their care and making the psychological impact on them worse.
However, chief nurse of the Trust, Gill Hunt, clarified that there has to be a duty that considers giving patients the choice to opt out of communication if they don’t wish to discuss their past care.
Fellow non-executive director, Adam Crampsie, also raised concerns about doing the lookback year on year.
He said: “It seems like it gives us more options to walk away and less of a firm commitment.”
University Hospital of North Durham in Durham City. The Northern Echo interview CEO of the County Durham and Darlington NHS Foundation Trust, Steve Russell
However, Gill Hunt responded by saying: “All discussions will take part in public and this will keep us accountable moving forward and all decisions will have to be done in public.”
Concerns about its breast service can be traced back to 2015, when a trainee reported limited opportunities to gain operative experience.
In 2018, the Northern Cancer Alliance identified the trust as a regional and national outlier for high re-excision and benign excision rates.
The Care Quality Commission also raised concerns that year about delayed diagnoses, serious incidents, complaints and audit findings.
University Hospital of North Durham in Durham City. CEO of the County Durham and Darlington NHS Foundation Trust, Steve Russell
A year later, NHS England’s Getting It Right First Time programme identified the trust as a negative outlier for high mastectomy and re-excision rates and low immediate reconstruction rates.
Further concerns followed in 2021 and again in 2023 and 2024.
By 2024, an external review found around a third of cases examined fell into the highest-concern category, while the trust’s re-excision rate was 30 per cent – double the regional average.
The Royal College of Surgeons later found “significant problems” in the service and recommended immediate external support.
Darlington Memorial Hospital
The trust has spent more than £500,000 on the review programme so far.
Its papers say 283 patients already identified for review would not have been found through the trust’s original data or criteria and were instead identified through the patient helpline, complaints, other hospitals or concerns raised by the current breast team.
The trust has said responsibility for identifying affected patients “should not fall on patients”.
Durham Police, supported by the National Crime Agency, is continuing to investigate whether any criminal offences were committed.
Amir Bhatti
Amir Bhatti, clinical lead for breast services from 2013 to 2024, currently has restricted clinical practice while an internal trust investigation continues.
The trust has apologised to patients and families, saying standards were not consistently met, and failures in care, governance and oversight caused distress and harm.
The extended review will now begin working backwards year by year, with the possibility that thousands more patient records could ultimately be examined.