County Durham and Darlington Foundation Trust (CDDFT) has expanded its review into women who had their breasts unnecessarily removed under a "pay per patient" outsourcing deal. The trust has already reviewed 514 breast cancer surgeries between 2023 and 2025, finding 20 patients had unnecessary mastectomies and 315 patients suffered harm.
The trust board has now decided to start a major review that could go back to 2015, expanding the probe to include over 4,500 procedures in total. Police have also launched an investigation.
Financial incentive identified
The scandal could have profound implications for outsourcing treatments to private clinics, which is widespread across the NHS. An independent review identified a "clear financial incentive" to carry out more operations.
Steve Russell, the trust's chief executive, addressed an emergency board meeting to assure cancer patients that care at its hospitals was now safe. He said: "None of none of this changes or in any way seeks to diminish the harm that has historically been caused and the actions that we need to take to support women and their families."
The trust has apologised "unreservedly" for the harm caused. Its board chair Alison Marshall said: "I would like to offer a sincere apology to all the women and their families who have been affected by the failings in our breast services. I can't imagine the impact that has had."
Patient speaks out
Denise Howarth is one of 20 women told by CDDFT they were given mastectomies unnecessarily. Speaking previously, the 51-year-old mother-of-two said: "I've lost so much confidence. I feel robbed of the person I was before. As a woman, losing a breast has a huge impact on you."
A board meeting decided to start by reviewing cases of women operated on in 2022 before pausing and assessing whether to expand the probe to include cases from earlier years. They rejected a proposal with a firm commitment to review all cases back to 2015, which would have seen cases from all years reviewed in one go.
At each stage the trust will now reassess whether to continue its investigation and review cases from earlier years. If all years are reviewed back to 2015, the board heard that this will take five years to complete.
Criminal investigation underway
Gill Hunt, chief nurse at the trust, said: "We absolutely know that the standards our patients have the right to expect were not consistently met historically in our breast services. And the purpose of today's discussion is to consider and agree the next steps in the look back process. both in terms of scope, both in terms of time frame and in terms of our approach."
Denise, and other patients, have since been interviewed by Durham Constabulary as part of an investigation to establish if any criminal offences have occurred. The National Crime Agency said its major crime investigative support unit is assisting Durham Police.
Denise had been diagnosed with grade 1 slow growing cancer in 2023 after discovering a lump in her breast. She initially underwent a lumpectomy, then a mastectomy, as well as eight rounds of chemotherapy and radiotherapy. She was told by the NHS in September 2025 that she could have been offered a second lumpectomy rather than full breast removal. This option had never been discussed with her. She has instructed Hudgell Solicitors to represent her in taking legal action against the trust.
The trust is inviting anyone with concerns about their breast care to get in touch on 0191 333 2126 or at cddft.breastservices@nhs.net.
