County Durham and Darlington NHS Foundation Trust is sharing a further public update on the major programme of work to improve its breast service, support affected patients and families and ensure the highest standards of care for the future.
The Trust has again offered a heartfelt and unreserved apology to everyone who has been affected.
Steve Russell, CDDFT Chief Executive said: “We are deeply sorry for the distress and harm that has been caused. We know this has had a profound impact on women and their loved ones. We are committed to listening, to being open about what we are doing and to making the improvements needed to provide safe, high quality care to all our patients.”
Following the Royal College of Surgeons report in March 2025, the Trust began a complete review and redesign of the breast service.
An experienced external oncoplastic breast surgeon was brought in to lead the stabilisation and transformation, alongside the appointment of two new specialist oncoplastic consultant surgeons.
This has allowed the service to move to a modern, guideline-driven model of care, in line with national best practice.
Dr Shafie Kamaruddin, Acting Medical Director for CDDFT said: “We have fundamentally changed the way the service works from diagnosis, to surgery, to follow-up care. Every patient is now discussed by a full team of specialists and treated using the most up-to-date national guidance. Our focus is on safe care, excellent outcomes and making sure patients are fully involved in decisions about their treatment.”
The Trust has also modernised its one-stop breast assessment clinics, which are the first and most important step in a patient’s diagnostic journey, started a major upgrade of breast imaging technology, overseen by an external specialist breast screening radiologist and introduced a dedicated clinic for patients with breast pain, improving their experience and reducing unnecessary investigations.
This means patients now receive a more consistent, more reassuring and higher-quality assessment from the moment they enter the service.
Support is available
A comprehensive support offer is in place for patients and families, including direct contact and clear duty of candour processes. This also includes recognising the lasting psychological impact such experiences can have and the Trust is fully committed to ensuring that psychological wellbeing is supported. Find out more.
These changes are already making a measurable difference as the number of women needing a mastectomy has fallen to the national average, immediate breast reconstruction rates have tripled, the need for second operations to fully remove cancer has halved, more than 80% of patients now have day-case surgery and far fewer patients need diagnostic surgery.
Over a third of cancer operations now involve advanced oncoplastic techniques, giving better cosmetic and recovery outcomes.
Patients who have completed treatment are now offered a supported patient-initiated follow-up programme, so they can contact the service directly if they have concerns rather than relying on a fixed appointment schedule.
New specialist clinics are also being developed for people experiencing side effects of cancer treatment.
Gill Hunt, CDDFT Interim Chief Nurse said: “We are truly sorry for the pain that has been caused. We are determined to learn, to change and to be open about our progress. These improvements are already making a real difference for patients.
“However, we know that there is more to do, some patients are still waiting longer than they should be for their first appointment with us and we continue to need support from neighbouring trusts. We will continue to work on further improvements to deliver the best care for our patients. We will also continue to update our communities as this work moves forward.”
Alongside the service improvements, the Trust continues the look-back review of past surgical cases to identify any patients who may have experienced harm.
The current phase is focused on patients treated between 2023 and early 2025, with earlier years to be considered afterwards.
This is a complex clinical process and there is not yet a fixed completion date.
Acting CDDFT Medical Director, Dr Kamaruddin added: “We are working with independent clinical advisors to support the look back exercise. We are contacting patients directly where these reviews raise any concerns which we feel require further investigation. The patient support and information line also continues to run for any patients who haven’t been contacted but feel concerned or would like to share their experiences with us.”
To date, between 2023 – beginning 2025, 1, 472 cases have been identified for review. 315 of these have been completed with 51 incidents of severe or moderate harm identified.
The information and support line and email has recorded 484 contacts, although some of these will be with the same patient.
A comprehensive support offer is in place for patients and families, including direct contact and clear duty of candour processes. This also includes recognising the lasting psychological impact such experiences can have and the Trust is fully committed to ensuring that psychological wellbeing is supported. The specialist Psych-oncology service has been extended to provide expert assessment and intervention to help individuals address and manage the psychological impact of their experience.
Head of the service and Consultant Clinical Psychologist, Nancy Vanderpuye said: “We know that experiences like this can have a deep and profound emotional impact. This service aims to offer help as quickly and flexibly as possible, with care fitting around the needs and preferences of the person receiving it.”
The Trust’s full response to the independent review and its improvement plan are published on its website and progress will continue to be reported at the Trust’s Open Board Meetings.