Letters Response

Stafford breast surgeons reply to BMJ news article

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7625 (Published 13 November 2012) Cite this as: BMJ 2012;345:e7625
  1. R Gendy, consultant breast surgeon1,
  2. R Vidya, consultant breast surgeon1
  1. 1Stafford Hospital, Stafford ST16 3SA, UK
  1. Raafat.Gendy{at}midstaffs.nhs.uk

The title of Dyer’s news story “Breast surgeons are referred to GMC for refusing to take part in a review of their unit” is factually incorrect.1 We, the breast surgeons in Stafford, have never refused a review of our unit. On the contrary, we were the first to recommend and fully support a broadly based review.

The unsatisfactory Cancer Peer Review report was related to the repeated problems in appointing a lead clinician and the uploading of incorrect information by management. The breast unit had no lead clinician for several months. This was followed by the appointment of an inappropriate lead (later removed), and then a third lead clinician was appointed (not a breast specialist). The poor compliance with the peer review measures was related to the uploading of the incorrect information (operational policy).

The clinical aspect of the service in Stafford, like any other breast service, is monitored by regular national and regional audits and external reviews. None of these has identified concern with the clinical standards in Stafford Breast Care Unit. Even the peer review report did not identify any clinical concerns other than a misunderstanding about a WHO surgical checklist, which was later corrected. The misunderstanding arose because the review team looked at an old form (no longer used) and did not notice that a new form was in place.

Following an unsatisfactory peer review of the unit, we called for a broad external review to address the issues that led to the unsatisfactory report. It is not in the public interest to use an irrelevant Royal College of Surgeons’ review to divert attention from the real reasons that led to the unsatisfactory report. We believe that it is in the interest of patient safety to take an approach based on openness and transparency to restore this service to what it was before.

For the above reasons we do not believe that the Royal College of Surgeons (the current invited review mechanism) would address the relevant issues (including management issues) because its terms of reference are narrow.

Our views have been widely supported by colleagues. In the absence of any clinical problems (with the surgical care), several members of the breast multidisciplinary team and local general practitioners have expressed the view that a review by the Royal College of Surgeons is not only unwarranted but could unnecessarily escalate patient anxiety and further destabilise the unit.

We have explained our views to both the royal college and the General Medical Council, and we are continuing to work with the trust management to arrange a broadly based review. We are supporting the effort to resolve the problem and restore harmony and team working to the unit. We understand that the commissioners first requested a Royal College of Surgeons’ review but later agreed to a different review, and that is the view we are taking and looking forward to.


Cite this as: BMJ 2012;345:e7625


  • Competing interests: None declared.


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