For more than a decade, the County Durham and Darlington NHS Foundation Trust (CDDFT) in north-east England has been at the center of a spiraling scandal over its breast cancer services, with hundreds of women reporting trauma, unnecessary surgeries, and a profound loss of trust in their care. A series of damning reports, patient testimonies, and investigative documentaries have now laid bare a pattern of systemic failures, outdated practices, and troubling conflicts of interest that have left lasting scars on both patients and the wider community.
On November 24, 2025, a 232-page report commissioned by CDDFT pulled no punches, concluding that the trust’s breast cancer unit had suffered from “a decade of systemic failures in clinical oversight, governance, and leadership.” According to the BBC, women treated at the facility described feeling “butchered” and deeply traumatized by their experiences, with some likening their treatment to being on a “conveyor belt.” The review found that avoidable harm was widespread: delayed diagnoses, unnecessary mastectomies and axillary clearance procedures, and benign surgeries that were never clinically indicated.
“Patients experienced avoidable harm, including delayed diagnoses, unnecessary mastectomies and axillary clearance, and benign procedures that were not clinically indicated,” the report concluded, as cited by BBC and AFP. The emotional and psychological toll was immense, with many women left physically scarred and emotionally devastated. One woman, Dawn Gillott, recounted, “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.” She added, “Was my mastectomy necessary? Maybe it wasn’t. Maybe I could have had a lumpectomy.”
The scale of the crisis is staggering. More than 200 cases are currently under investigation at CDDFT, with 43 involving significant harm and one death being closely examined. Nearly 1,600 patient records from the breast service, stretching back to 2023, are being scrutinized as part of a wider review. According to the Sunderland Echo, the failures included outdated clinical practices that did not meet national guidance, leading to both delayed diagnoses and missed cancers. There was also a high rate of repeat operations, a low uptake of immediate breast reconstruction after mastectomy, and a pattern of surgeries that appeared to be carried out “too quickly.”
One particularly troubling aspect, highlighted by the BBC’s Local Investigations team, was the outsourcing of patient appointments to private clinics. Between 2019 and 2025, CDDFT paid nearly £6 million to private out-of-hours clinics run by one of its own breast cancer surgeons, Amir Bhatti. These clinics operated at Darlington Memorial Hospital and The Spire in Washington, with Mr. Bhatti serving as a director of Durham Surgical Services, one of the companies behind the clinics. From 2022 to 2024, these clinics saw 8,000 of 13,500 referred breast cancer patients. The review, led by governance expert Mary Aubrey, flagged these arrangements as “significant concerns regarding conflicts of interest, undermines clear lines of accountability, and may compromise the trust’s capacity to ensure high standards of care.”
For patients like Kate Driver, the impact was deeply personal. After finding a lump before Christmas 2023, she was referred by her GP to a specialist appointment at a private clinic held at Spire Hospital in Washington. The test she received, a fine needle aspiration (FNA), is not considered best practice for breast biopsies due to the risk of missed or delayed diagnoses. Kate waited weeks for answers, describing the process as slow and chaotic. “I couldn’t eat, I couldn’t sleep. It just made it felt like no-one really cared, no-one was taking it seriously,” she told the BBC. Eventually diagnosed with cancer, Kate was told she would need a mastectomy but was advised against immediate reconstruction—advice later contradicted by a second opinion in Newcastle. The trust has since apologized to her, admitting her care “fell below acceptable standards.”
Data from 2024 revealed that almost half of women diagnosed with breast cancer at CDDFT underwent a mastectomy, compared to a UK average of about 27%. Even more concerning, only 7.5% of those mastectomies involved immediate breast reconstruction, far below the national recommended minimum of 25%. The review found that operations were often performed rapidly, with one mastectomy and lymph node surgery completed in just 28 minutes—raising questions about the quality and thoroughness of care.
Behind these numbers are stories of women who felt stripped of their dignity. Catriona McEvoy, from Stanley in County Durham, described how a doctor sliced open her infected breast without warning or pain relief—a procedure that left her feeling violated and neglected. The doctor responsible is now under supervision, according to the trust. Another recurring theme was the sense of being rushed through treatment, with clinics running late into the night and surgeons racing through long lists. Professor Ian Fentiman, emeritus professor of surgical oncology at King’s College London, commented, “Obviously there was an incentive to see as many people as possible because of the per capita payment.”
Financial arrangements were not the only area of concern. The independent review by Mary Aubrey, as reported by multiple outlets, found that governance within the breast surgery service was “inadequate, inconsistent, and failed to ensure patient safety.” The trust lost its training center status in 2012, and repeated warnings were ignored over the years. The review also highlighted that millions of pounds were spent delivering services at private clinics where trust consultants had roles, creating potential conflicts of interest and risks to clinical standards.
In response to the mounting criticism, the trust has issued repeated apologies and promised sweeping reforms. Steve Russell, the newly appointed chief executive of CDDFT, told the BBC, “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. 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 added, “I’m determined to make changes so that it doesn’t happen again.”
The trust has since stopped using out-of-hours private clinics for breast cancer services, and Mr. Bhatti is no longer the clinical lead. Two new oncoplastic breast surgeons have been brought in, and the service is now said to be delivering care to national best practice standards, with external consultant support. As the fallout continues, a BBC documentary, “Hidden Scars: An NHS Scandal,” aired on November 28, 2025, bringing further attention to the stories of those affected and the urgent need for lasting change.
The events at County Durham and Darlington NHS Foundation Trust serve as a stark reminder of the consequences when oversight fails and patient voices go unheard. While reforms are underway, for many women, the hidden scars—both physical and emotional—will remain long after the headlines fade.
