RQIA report: woman at risk of developing breast cancer while on plastic surgery waiting lists

The review states that breast cancer sufferers are "not being offered an acceptable or equitable service" here due to long waiting times and a failure to comply with best practice standards. Picture by Rui Vieira, PA Wire
Andrew Madden

WOMEN with a high-risk of developing breast cancer are in danger of being diagnosed with the disease while on an "unacceptably long" waiting list for preventative treatment, a watchdog report has warned.

The concerns were highlighted in a review of the north's plastic surgery provisions by the Regulation and Quality Improvement Authority (RQIA).

Women who test positive for the inherited BRCA gene have an 85 per cent chance of developing breast cancer and 45 per cent risk of ovarian cancer.

Those who have tested positive are able to receive preventative plastic surgery, where a mastectomy and breast reconstruction are carried out in one major operation.

This drastically lowers their risk of contracting the disease.

However, the report reveals there is only one microsurgical breast surgeon to deal with these complex cases.

The reviewers of the RQIA report have raised concerns that these patients are not being treated quickly enough and this is putting them at risk.

"The waiting time even for the BRCA gene positive women means some might develop breast cancer before their mastectomy and reconstruction could be performed, which exposes the trust to considerable risk," they state.

They also expressed concern that "women in Northern Ireland with breast cancer were not being offered an acceptable or equitable service and the demands on the single surgeon were also unacceptable".

In Northern Ireland, the south eastern health trust has overall responsibility for plastic surgery services, but the service is currently being managed and funded separately across the Belfast and south eastern trusts.


There are currently 10 whole time equivalent (WTE) plastic surgery consultants employed across the two bases.

These consultants are serving a population of 1.8 million and the RQIA report states that this staffing complement is "not considered sufficient to meet the demands and expectations of the service".

According to the most recent workforce report from British Association of Plastic, Reconstructive and Aesthetic Surgeons, 23 plastic surgery consultants would be required to service the north's needs.

The report identifies a range of shortcomings across the entire service, primarily relating to waiting times for patients, including burns victims and those being treated for skin cancer.

"Waiting times have been adversely affected by the year-on-year increase in emergency medical and surgical admissions, made worse by winter peaks and the capping of elective admissions," the report states.

SDLP assembly member Mark H Durkan said the findings were "concerning" but it was important not to blame staff for the shortcomings.

"There needs to be greater capacity to assist staff and the service meet its targets to provide the highest standard of care," he said.

"I will be writing to the department of health to seek further information about the pressures that exist in an effort to work with all partners to protect patients."

In conclusion, RQIA recommended the setting up of a "single service, with recurrent funding to employ additional consultant plastic surgeons to meet the increasing demands".

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