Despite years of repeated staff concerns, CQC evades, denies receiving any whistleblower concerns about breast cancer surgery at CDDFT, can’t say if it has learned lessons but has now taken enforcement action on trust surgery services

Dr Minh Alexander retired consultant psychiatrist 6 January 2026

This is a post-script to my last post on the still unfolding breast cancer surgery scandal at County Durham and Darlington NHS Foundation Trust (CDDFT).

Whistleblowing governance failures harmed Durham breast patients despite NHS Freedom To Speak Up policy

An independent investigation (the “Aubrey Report”) reported major governance failures by trust executives and failures to act on red flags over many years. These included concerns from multiple sources, including staff whistleblowers.

A missing element to the whole picture was any apparent contribution by the regulator, the Care Quality Commission (CQC), to the identification of the failures.

Accordingly, I asked the CQC via FOIA for information on public interest disclosures by trust staff about the breast cancer surgery service and other information. This is because the CQC is a ‘prescribed person’ under UK whistleblowing law, which is responsible for receiving concerns from the staff of regulated health and social care providers.

It seemed inconceivable that at least some staff who had been so concerned for so long would not have sought help from the key regulator responsible for overseeing health services.

Implausibly, the CQC denied that it had received any whistleblowing disclosures from CDDFT staff about the breast cancer surgery service. There is some wiggle room in that CQC advised it was unable to manually review the records within the FOIA cost limits and relied only on searching for key words. But even so, it is still remarkable that a key word search yielded nothing.

It should be noted that CQC is now aggregating provider staff whistleblowing disclosures with concerns from other sources, which inflates numbers and contributes to its claims of Section 12 cost exemptions under FOIA.

I further asked the CQC to confine its search to trust staff disclosures to the local CQC inspection team in the last five years. It denied that these were recorded any differently. CQC advised that it had received 520 concerns about CDDFT in the last five years and claimed that it would still exceed FOI cost limits for these to be manually reviewed for staff disclosures relating to breast surgery.

I am almost certain the CQC will have received disclosures about CDDFT breast surgery services at some point, given the level of concern and the very long period of time over which the problems occurred. We may receive confirmation in due course that such staff disclosures were made, especially if any of the staff who made disclosures about the breast cancer surgery service learn that CQC has denied receiving them/ avoided answering.

But in swerving the questions about staff whistleblowing at CDDFT, the CQC lays itself open to criticism of general negligence in tracking whistleblowing activity in NHS organisations – a vital governance task. If it has really stopped differentiating the various sources of concerns, as it now claims, it must have no grip. I will write to the latest CQC CEO about this. Alternatively, the CQC may eventually decide that it can tell us about whistleblowing at CDDFT after all.

This is the FOI correspondence with the CQC:

CQC FOI response 30 December 2025 whistleblowing on breast cancer surgery CDDFT

CQC FOI response 5 January 2026 whistleblowing on breast cancer surgery CDDFT

CQC evaded a question about whether it had been alerted to the breast cancer surgery issues by other regulators:

“3. Please disclose if since 2012 the CQC has been alerted by other regulators such as Monitor, NHS Improvement or NHS England of any pf the problems in the breast cancer surgery services at CDDFT? If so, please give dates and relevant details.

We do not keep a central record of information that can easily answer this point.”

Although CQC did not clearly say whether it had specifically inspected breast cancer surgery in the years concerned, the CQC disclosed that it re-inspected the trust’s surgery services in October 2025, and has taken enforcement action.

“6. Has the CQC inspected the trust since 2019? Does the CQC have any plans to inspect CDDFT in the next year?”

The trust’s surgical services were recently inspected by the Care Quality Commission. We carried out an inspection of surgery services in October, and due to concerns found, we have taken enforcement action against the trust to ensure the safety of people using services.”

As far as I can see, the report from this inspection has not yet been published on CQC’s website.

I asked CQC about data held on serious incidents relating to CDDFT’s breast cancer surgery service. CQC advised that data is held for only three years and not in a form which allows analysis of incidents specific to the breast cancer surgery service: “we cannot break it down to identify incidents specifically about breast cancer surgery services”.

This would obscure detection and monitoring of any patterns.

Regarding whether CQC has reviewed itself in the light of the Aubrey report, and has identified any lessons to learn from the breast surgery scandal, CQC replied thus:

“5. Please disclose if CQC has assessed whether it has any lessons to learn arising from events at CDDFT and the findings of the Royal College of Surgeons invited review and the Aubrey report into breast cancer surgery at CDDFT. If so, has the CQC conducted any internal review of its inspection process at CDDFT or does it plan to do so?

Following reasonable searches, no recorded information has been located with which we can answer this specific part of your request.”

How reassuring.