A peer review of breast cancer surgery services at Mid Staffordshire Foundation Trust has uncovered a catalogue of concerns and safety fears - despite the trust assessing them as being largely compliant with national standards.
While the trust’s self-assessment said the services were almost 94% compliant with standards drawn up by the National Cancer Action Team peer review programme, the team’s peer review said they were just 9.7% compliant.
The peer review, undertaken in March, described the the trust’s multi-disciplinary team as “deeply dysfunctional”.
The team also noted “open hostility” between clinicians and the trust management, which it said was “incompatible with an open safety culture”.
It added: “The review team is seriously concerned about the effect on patient management and safety… and continues not to be assured of the quality and safety of the service.”
The peer review said Mid Staffordshire’s two breast surgeons did not support the trust’s new lead clinician - something it said “could seriously impede the addressing of the multiple problems faced by the service”.
Every single form supposed to be used for confirming the correct site for surgery was left blank, the network reported. This “could lead to surgery being undertaken erroneously on the wrong anatomical site and needs to be addressed urgently”.
Oncology notes were not available to the wider health community in the event of an emergency.
The review also found there was the possibility of “selection bias” by the surgeons on mastectomy and immediate reconstruction surgery. It recommended an urgent audit of practice was carried out.
Mid Staffordshire’s team was unaware of national evidence supporting surgery techniques without the use of drains. Meanwhile, it took two weeks to get the results of MRI scans performed at Burton Hospital, just 25 miles away.
The review group said the trust’s team “provided no evidence, no knowledge about or understanding of the local results of the national cancer patient survey data” and “they could not describe how many of the various procedures for breast cancer they actually performed”.
Trust medical director Robert Courteney-Harris said breast surgery services at the trust were safe. He said concerns were “being addressed”. He added: “We continue to work closely with our commissioners so that they are kept fully informed.”
Information supplied to HSJ