Breast services review could be expanded at County Durham and Darlington NHS Foundation Trust

The Trust’s Board is considering the future scope of its Breast Surgery Lookback Programme following longstanding concerns about clinical practice, governance and oversight within its breast services. The Trust has acknowledged that standards patients had a right to expect were not consistently met and that failures caused “distress, uncertainty and harm” to some patients and their families.  

Fletchers Solicitors is already representing women affected by the issues within the service and has previously called for the review to be widened so that patients who may have suffered harm are not excluded simply because their treatment falls outside the existing criteria.  

According to papers prepared for the Trust’s Extraordinary Open Board Meeting on 24 September 2026, 539 patient reviews had been completed as of 2 September. 

Following independent expert assessment, these included one case involving death, 19 cases of severe harm, 59 cases of moderate harm and 242 cases of minor harm. A further 218 cases were ultimately graded as involving no harm. The Trust states that statutory Duty of Candour applies to cases involving death, severe or moderate harm.  

The most commonly identified concerns leading to Duty of Candour included treatment not being aligned with best practice, excessive surgery and delayed diagnosis. The Board papers cite 38 cases involving treatment not aligned with best practice, 32 involving excessive surgery – including mastectomy where a wide local excision would have been appropriate – and 20 involving delayed diagnosis. Some patients feature in more than one category.  

Earlier reviews had already highlighted significant concerns. A Northern Cancer Alliance review of patients treated in 2023 found around one-third of reviewed cases fell into its highest category of concern. It also highlighted a re-excision rate of 30%, twice the regional average of 15%. A subsequent Royal College of Surgeons review identified significant problems within Breast Surgery Services and recommended immediate external support.  

The Board has been presented with four possible approaches to the future lookback. 

These range from maintaining the current timeframe of January 2023 to February 2025, through to extending the review progressively year-by-year towards 2015, or carrying out a wider lookback covering the period back to 2015, when the Trust says systemic failings first became evident.  

The papers acknowledge that a wider review would create considerable practical challenges. Around 4,500 cases could require review if the lookback extends to 2015, with an estimated completion time of approximately five years based on the current capacity of 80 reviews per month.  

However, the Trust’s options appraisal also recognises the risk of missing harm if the existing timeframe is retained. In considering the narrowest option, the paper states that harm has already been identified in cases before 2023 and that without extending the review, further cases may only be identified if patients themselves initiate a review.  

Francesca Paul, Partner and Group Action Lead at Fletchers Solicitors, said: 

“The findings set out in these latest Board papers reinforce why it is so important that the scope of this review is wide enough to identify every woman who may have been affected. 

“We agree that the scope should be widened. The Trust’s own figures show that patients who would not have been captured by the existing criteria have subsequently been identified as having suffered harm. That makes it particularly important that the process does not rely solely on women knowing that something may have gone wrong and coming forward themselves. 

“No woman should be left without answers or access to any treatment and support she may need simply because of when or how she received her care. Where failures have caused avoidable harm, those affected should also have a clear avenue to understand their legal options and seek recourse where appropriate. 

Fletchers Solicitors’ specialist Group Actions and Medical Negligence teams are already supporting women who have concerns about breast screening, diagnosis, surgery and treatment provided by County Durham and Darlington NHS Foundation Trust. 

Some of the women being supported by Fletchers fall outside the original recall criteria but have nevertheless raised serious concerns about their care. The firm has previously called on the Trust to widen its recall and proactively contact patients who could potentially have been affected.  

Patients do not need to have received a recall letter to speak to Fletchers. Anyone concerned about breast care they received at Darlington Memorial Hospital, University Hospital of North Durham or elsewhere within the Trust can speak to the specialist team about their individual circumstances and the options available to them.  

Find out more about the County Durham & Darlington breast care claims and how Fletchers can help