Serious concerns raised over Lancaster’s breast screening service

The Royal Lancaster Infirmary
The Royal Lancaster Infirmary

Serious concerns have been raised about management arrangements and working relations within the Royal Lancaster Infirmary’s breast screening unit.

An investigation by Public Health England (PHE) has warned that if the culture within the unit is not immediately addressed there will be a serious impact on the future safety of the service.

PHE undertook a review into the breast screening service provided by University Hospitals of Morecambe Bay Trust (UHMBT) earlier this year, following concerns raised by staff within the unit.

Sue Cohen, PHE’s National Quality Assessment lead, NHS Screening Programme, said: “The conclusion of this external review is that the reading of mammograms and testsin assessment clinics were meeting national minimum standards, however the review found that the way tests in assessment clinics were carried out in some cases could be improved.

“The review also found that the working environment in the breast screening unit was poor and that this needed to be improved urgently, so that the breast screening programme can continue to provide a safe service. The report makes recommendations to the breast screening service on how they can do this.

“PHE is committed to support the trust and NHS England in making sure appropriate plans are put in place to ensure national standards continue to be met and a high quality of service is provided. We are committed to the very best outcomes for women who use the NHS Breast Screening Programme.”

The report said that as well as the culture and leadership changes that are urgently required, screening schedules should be slowed down for a short time period to ease pressure on the service.

A review of the managerial arrangements for the service is also urgently required to ensure adequate inclusive leadership to support the recommended changes to processes.

Other recommendations included the continuation of team building workshops, which the trust has already introduced, refresher training for radiologists, a visit to another breast screening practice, and a change in culture in relation to auditing.

George Nasmyth, medical director at UHMBT, said: “Not everybody has been adhering to the best practice, so we want our staff to go and visit units that have higher best practice than we do, so that we can assure ourselves that we have a safe service.

“Working relationships and leadership arrangements will change, and we will also be replacing the ultrasound machine.

“We’re not going to blame and shame people, because if we do that, we drive bad practice underground rather than eliminate it.

“The main risk for the breast screening unit now is that if changes are not implemented we may not be able to go forward with a safe service.

“It’s important to note however that a national cancer patient survey showed that 96 per cent of patients rated their experience good or excellent.

“We want women to have confidence in the service. Early diagnosis is the most important thing, and women need to have confidence in the process.”