Breast cancer survivors waiting years for reconstruction surgery are starting to be seen on the NHS – but why did it have to take so long?
And why did it not happen before women took the brave step of sharing their harrowing experiences with the P&J?
We reported on January 12 that NHS Grampian is finally starting to carry out delayed breast reconstructions for women facing the longest waits.
One week on, we look back at what caused the delays, how many women are affected, and the situation at other health boards.
Why are women waiting years for delayed breast reconstructions?
NHS Grampian admitted a number of patients waited “vastly longer” than they would have liked for their reconstructive surgery.
During the pandemic, some breast cancer patients had mastectomies but were unable to get reconstruction at the same time.
Several women told the P&J they were led to believe they could be waiting around a year or two but, after several years, learned they were still at the bottom of the list.
This is because priority goes to patients with active cancer or trauma due to pressures on surgical capacity.
Patients waiting on delayed reconstruction, who no longer have cancer, have therefore been languishing at the bottom of the list.
How many women are affected in Grampian?
Prior to the pandemic in 2020, eight patients were waiting for delayed reconstruction, with the longest waiting patient having waited since 2016.
The latest figures from November show the list stands at 34 with the longest waiting patient listed in 2017, three years before the pandemic.
How long are women in Grampian waiting?
Using freedom of information legislation, we uncovered the average wait for a delayed reconstruction in Grampian is three and a half years.
The data from November 6 shows nine patients waited longer than three years and eight patients have been on the list longer than four years.
What about other health boards?
Patients faced delays across Scottish health boards for reconstruction surgery.
There are two types of breast reconstruction surgery available to patients who received a mastectomy during cancer treatment.
One involves placing an implant under the skin of the chest wall, called implant-based reconstruction, or replacing the breast with tissue from another part of the body, known as free flap reconstruction.
The latter is a complex surgery which requires specialised plastic surgery services available only at the four main plastic surgery centres in Scotland.
At NHS Lothian, nine women were on the list for over a year and fewer than five women were waiting under two years.
The data shows no patients were waiting longer than three years at the central belt health board.
Meanwhile, at NHS Greater Glasgow and Clyde, the data shows five women were on the list longer than three years, and four were on the list for four or more years.
NHS Tayside has not yet responded to the freedom of information request.
Is there a solution?
NHS Grampian confirmed earlier in January that it has undertaken a “small number” of delayed breast reconstruction surgeries in the last few weeks, with further operations planned for next month.
A spokesman said: “Where patients are fit and available, we are prioritising those who have faced the longest waits.”
The health board has said it will take “some time” to tackle the backlog of patients.
An NHS Tayside spokeswoman said a number of patients were scheduled in for this surgery in December and the service is exploring “further surgical opportunities” for the remaining patients.
NHS Greater Glasgow and Clyde performed delayed reconstructions for cases waiting longer than 104 weeks (around two years).
Delayed reconstruction has been undertaken for 75 patients at this health board since the Covid-19 pandemic.
The Scottish Government says it is engaging with health boards to develop a progress plan for patients with delayed reconstruction.
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