The Adults, Wellbeing and Health Overview and Scrutiny Committee was scheduled to consider updates on breast services, the Shotley Bridge Hospital project, and the County Durham and Darlington NHS Foundation Trust's Quality Accounts. The meeting was scheduled to receive presentations from representatives of the County Durham and Darlington NHS Foundation Trust on these key areas.

Breast Services Update

The committee was scheduled to receive a presentation on an update regarding breast services, focusing on a review of past care and improvements to the service. The report pack indicated that lookback reviews were examining historic clinical records to identify patients where harm may have occurred, with cases identified from a helpline or through review of current cases. A separate programme was also strengthening the current service, including clinical practice and oversight.

The review of past care had identified 539 completed reviews by 2 September 2026, with recorded harm levels including one death, 19 severe cases, 59 moderate cases, and 242 minor cases, alongside 218 cases where no harm was identified. Concerns included treatment that did not follow best practice, excessive surgery, and delays in diagnosis. The Board was scheduled to consider a phased extension of the review, working backwards towards 2015, with independent clinical advice and patient involvement informing each stage. The report pack highlighted that patient voice and support were central to the next stages, with patients asking for consideration of care before January 2023, open explanations of decisions, timely psychological support, and respect for individual wishes regarding contact. Safeguards for the next stage were to include the continuation of the helpline and independent clinical review, ongoing support for patients already identified as harmed, and planning for specialist reviewers and patient support.

Service improvements were also scheduled to be discussed, including closer working with Newcastle Hospitals NHS Foundation Trust, stronger clinical leadership, and standardised care pathways. However, pressures remained, including a backlog of 197 patients with an average wait of six weeks, and staff shortages and sickness affecting capacity.

Shotley Bridge Hospital Project Update

The committee was scheduled to receive an update on the Shotley Bridge Hospital project. The report pack indicated that the project had moved into site delivery, with the Final Business Case, assurance, and remaining design decisions being progressed. The project was a Wave 1 scheme with £63.4m in MHP funding. Remediation had started on 7 September, with the Final Business Case planned for submission in January 2027 and expected construction start in mid-2027.

CDDFT Quality Accounts Update

A presentation on the County Durham and Darlington NHS Foundation Trust's (CDDFT) Quality Accounts for 2026/27 was scheduled. The report pack outlined that the 21 priorities from 2025/26 had been concentrated into nine priorities for 2026/27. These priorities included continuity with 2025/26 work on infection prevention, flow and corridor care, deterioration, fundamental care, and strengthened focus areas on mortality outcomes, learning culture, digital and governance, and the Aubrey Report. Falls and maternity were no longer standalone Quality Account priorities but were to be monitored through existing groups and Trust governance.

The report pack detailed that Quarter 1 of 2026/27 focused on establishing baseline data and building foundations for improvement, with examples of work in progress including reducing corridor care. The committee was also scheduled to be briefed on governance and risk, with a strengthened risk management framework implemented and risk registers reviewed. Targeted risk management training had been delivered, and early indications suggested a strengthening risk culture and frontline escalation processes. However, further work was required to strengthen the effectiveness of groups feeding into meetings, and medical engagement at governance meetings remained variable.

Staffing and training updates were also scheduled, including strengthened overnight medical staffing within surgery and the establishment of a mandatory junior doctor handover. The Acute Intervention (AI) Team was working collaboratively with resident doctors out of hours. Emergency drills had been established in theatre environments, and resident doctor meetings with tutors had been set up. F1 Surgery was reported as no longer being a GMC red outlier for overall trainee satisfaction. Trust-wide medical safe staffing requirements policy remained in progress, and actions implemented in January to ensure embedding with new junior doctor cohorts required revisiting.

Updates on incidents and complaints were also to be presented. Dedicated PSII Investigators were in post to ensure timely completion of investigations. Real-time feedback had been implemented in inpatient areas, with positive experience scores reported. The timeliness of Duty of Candour was improving, and an Experience of Waiting and Appointments Task and Finish Group had been established. While evidence of timely complaint and incident management was emerging, timeliness and consistency remained variable across the Trust, requiring continued focus and oversight. Further work was needed to embed learning from incidents, complaints, and PSIIs, and complaint volumes remained high.

Finally, the committee was scheduled to receive information on clinical risk assessments and documentation, including the implementation of 'M Pages' to support consistency in medical documentation across surgical services. Enhanced compliance focus on VTE risk assessment and patient observations was noted, alongside the rollout of CareAware Connect education. A consent audit programme had been established to assure the quality of the consent process. While compliance rates for EWS, Care Aware Connect, Consent Audits, and VTE Assessments were reported, further embedding of M Pages and trust-wide VTE assessment compliance were areas for continued focus.