Sharon Barbourand
Mary O'Reilly,BBC Local Investigations
Breast cancer patients suffered unnecessary mastectomies, delayed diagnoses and a lack of compassionate care at an NHS Trust in north-east England, the BBC has learned.
More than 200 cases are now * being investigated at County Durham and Darlington Foundation Trust (CDDFT) – 43 of these are reported to involve significant harm. One death is also being examined.
Women have told us they were left feeling “butchered” by surgery, while a leading expert says that what went on at the trust was “a textbook example of how not to carry out breast cancer management”.
In addition, we discovered that nearly £6m was paid out by the trust to clinics run privately by its main breast cancer surgeon.
In total, medical records of nearly 1,600 patients treated since 2023 are now * being examined following concerns about the service the trust offered.
An independent review into the running of CDDFT, carried out by governance specialist Mary Aubrey, has also been published this week. Among the shortcomings it highlights are:
- Outdated clinical practices that did not meet guidance on best practice, and led to delayed diagnosis and cancers being missed
- A high rate of “re-excision” (repeated procedures) and low uptake of breast reconstruction immediately after mastectomy
- Operations that may have been carried out “too quickly”
- Outsourcing of many patient appointments in a manner that created a “conflict of interests” and “posed a risk to clinical standards”
The Aubrey review says “persistent concerns” had been raised since 2012, when the trust lost its status as a training centre for breast surgery services. In the following years, it “failed to act on repeated warnings and evidence… which allowed unsafe and outdated practices to persist”.
CDDFT has apologised to “women and their families who have been harmed because of our substandard care”, and it admits that “over many years, warning signs were repeatedly missed or not acted upon”.
Delays and scars
Kate Driver, who is 31 and from Chester-le-Street, is one of several women we spoke to who had been treated by CDDFT's breast cancer service.
In the run-up to Christmas 2023, Kate found a lump in her right breast. She was referred by her GP to the trust for an appointment with a specialist.
Although this was an NHS appointment, it took place at a private clinic held at Spire Hospital in Washington, where she was seen by Mr Amir Bhatti, the trust's clinical lead for breast surgery.
He carried out a test known as a fine needle aspiration (FNA), during which a sample of cells is extracted to test for cancer.
What she did not know was that FNA tests are not considered best practice for breast biopsies, because they can produce inadequate samples, and lead to the risk of missed, incomplete or delayed diagnoses.
Kate's test results were supposed to be provided within 48 hours, according to the trust's website. In fact, the test was inconclusive, and Kate had to wait several weeks before she was finally told she had breast cancer.
“Waiting so long and having to chase everything up made it a hundred times worse than it needed to be,” says Kate. “I couldn't eat, I couldn't sleep. It just made it felt like no-one really cared, no-one was taking it seriously.”
More bad news was to follow. Kate was told she would need a mastectomy, but advised that because of her particular type of cancer, she should not have breast reconstruction at the same time.
“They were going to completely remove my right breast and leave me with nothing, just a big scar,” she says.
Kate sought a second opinion at another trust in Newcastle, where she was told there was no reason why she should not receive a breast reconstruction immediately after her mastectomy. She chose to be treated there instead.
The County Durham and Darlington NHS trust has apologised to Kate saying her care “fell below acceptable standards”.
She made a formal complaint about her treatment by Mr Bhatti, which she says left her traumatised.
Spire Healthcare says that treatment and follow-up care of the clinic's patients was the responsibility of CDDFT.
Mr Bhatti told us he was unable to comment on specific cases because of patient confidentiality and urged patients to contact the trust directly.
Research from 2024 shows that almost half of women diagnosed with breast cancer at the County Durham trust had a mastectomy. According to 2022 parliamentary evidence given by the charity Breast Cancer Now *, the UK average was about 27%.
In addition, only 7.5% of mastectomies carried out by CDDFT were followed by immediate breast reconstruction – far below the national recommended minimum of 25%.
Dawn Gillott is another breast-cancer patient whose treatment at the trust is being investigated.
She told us she had been given no option except mastectomy: “I felt like I didn't have a choice. It was ‘you're having this and that's all there is to it'.”
She says she has been left with a massive scar which has left her feeling “butchered”.
“I can't look in the mirror at myself after having a bath because the scar is just a constant reminder that it's horrific.”
The operation has also left Dawn in constant pain across her chest and under her armpit.
“Was my mastectomy necessary?” she reflects. “Maybe it wasn't. Maybe I could have had a lumpectomy.”
An ‘overly generous' arrangement?
Between 2022 and 2024, more than half of the patients referred to CDDFT for breast cancer tests or urgent investigation were – like Kate – initially sent to one of two private two-week-wait clinics paid for by the NHS.
Amir Bhatti ran these clinics, and he was also a director of one of the companies behind them – Durham Surgical Services.
The companies were paid on a per-patient, or per-appointment, basis – a set-up, the BBC has found, that cost the trust nearly £6m between 2019 and April 2025.
This arrangement was considered “overly generous” by some staff, who were interviewed for a Royal College of Surgeons (RCS) report into treatment and care at the trust, published earlier this year.
The clinics generally worked on an out-of-hours basis, seeing patients in the evenings and at weekends.
The RCS raised concerns about the high turnover of appointments, commenting that it was not unusual for one clinic “to run on until 23:30”.
“Obviously there was an incentive to see as many people as possible because of the per capita payment,” says Prof Ian Fentiman, emeritus professor of surgical oncology at King's College London.
A lack of compassion
The BBC has also heard allegations from breast cancer patients about a lack of compassion and care at the trust, in both its clinics and its hospitals.
Catriona McEvoy, from Stanley in County Durham, told us she felt women were being treated by the doctors “like a conveyor belt”.
She says she was shocked by the response from one doctor during a hospital appointment, after she told him her breast had become infected following a lumpectomy.
She says that, without speaking to her, offering her pain killers or asking her permission, the doctor just “flicked his surgical knife” and cut her breast to drain the infected area.
“There was no dignity in any of it,” says Catriona.
We contacted the doctor who Catriona says performed this procedure, but he declined to comment. The trust has told the BBC he is now * under supervision.
Serious concerns about the speed and quality of breast surgery were identified in the Royal College of Surgeons' report. “Some surgical procedures appeared to be undertaken with great swiftness,” it says.
These included a mastectomy and lymph node procedure performed in 28 minutes, and an excision of benign thickened breast tissue in 10 minutes, “which the review team considered to have been unnecessary”.
The RCS also noted “a very * high re-excision rate” – in other words, repeat operations.
The RCS review was “an appalling indictment” of a “third-rate” breast clinic service, according to Prof Fentiman. “In every way, things were being done wrongly,” he says.
It followed two other critical reports into the breast care service at CDDFT.
In 2019, an internal NHS Getting It Right First Time (GIRFT) report highlighted multiple concerns about breast surgery at CDDFT. The trust's executive director of nursing, Kathryn Burn told the BBC that the concerns in the report were discussed, but not much action was taken.
The GIRFT report, along with a 2024 review carried out by a team of experts at the Northern Cancer Alliance, was not made public until the BBC made a Freedom of Information request .
‘Not good enough'
“The important thing to do… is to say how deeply sorry I am, that women who have been cared for in our breast services have been let down by us,” says Steve Russell, who was appointed chief executive of County Durham and Darlington Foundation Trust in September 2025.
“I can only imagine the distress and pain that has been caused to the individuals and their families and the loss of trust and confidence in us as an organisation.”
“It is true to say that there were a number of missed opportunities. It was not good enough and it is not good enough that we were too slow to act on the information that was there.”
He adds: “I'm determined to make changes so that it doesn't happen again.”
As well as a new chief executive, a new interim chair of the trust has been appointed. NHS England told us it will “continue to support the new leadership and partner organisations to make the improvements required”.
In a statement, Mr Bhatti said he had been disappointed not to be given the opportunity to comment on the draft findings of the RCS report. He told the BBC it contained “some factual inaccuracies” which he believed led to “erroneous conclusions”.
He also told us that “serving the best interests of all our patients is of paramount importance” and that, when things go wrong, “we learn from this and make the necessary changes and improvements”.
Earlier this year, the trust stopped using the out-of-hours clinics run by Mr Bhatti. He is no longer clinical lead of the breast service, treating breast cancer patients or performing surgery, while investigations continue.
In a statement to the BBC, his spokesperson said: “Mr Bhatti has been raising concerns about the adequacy of equipment in the breast cancer department since May 2021. He looks forward to working with all those involved in any way required.”
If you, or someone you know, has been affected by cancer, BBC Action Line has a list of organisations that may be able to help.
Additional reporting by Ben Milne
