East Lancs breast screening boss: 'Colleagues never thought lives were being put at risk'

Dr Richard Dobrashian worked with Dr Kelly at Accrington Victoria Hospital during the time that the radiologist failed to identify cancer in 61 women.

They worked together for four years before they were joined by a third consultant, and eventually Dr Dobrashian replaced Dr Kelly as director of the unit.

Yesterday a damning inquiry report criticised Dr Kelly’s colleagues for not reporting the consultant radiologist for his failings.

Dr Kelly could not perform the latest ultrasound biopsy technique, despite it being the minimum requirement by national guidelines.

And the report said staff on the unit knew this but did nothing.

But Dr Dobrashian, a consultant radiologist with 10 years’ experience, said: “Yes, people were aware perhaps his work process was a little different, but at no point did we think women's lives were being put at potential risk.

“He was a senior, respected consultant that was working independently, and all of us expected him to be working to a high standard.

“There were never previously concerns that breast cancers were being missed. If any one of us had these concerns, all this investigation would have been done a long time ago.”

Dr Dobrashian was the person who uncovered Dr Kelly’s failings.

He said: “I took over the running of the unit in September 2008 and very quickly concerns over the work processes of this consultant came to me.

He said: “There was a case of a delay in diagnosis that I felt wasn't acceptable. In two cases I disagreed with the outcome.

“Two patients were immediately recalled to see me in person and found to have breast cancers, and that is when he was removed with immediate effect.”

The report into the unit said it was now safe and fit for purpose, and praised Dr Dobrashian for developing ‘strong clinical governance processes’.

Because Dr Kelly did not follow best medical practice, all staff now have to read and sign documents to say they have read, understood and use NHS breast screening guidelines.

Monthly meetings are held to ensure 100 per cent compliance.

Dr Dobrashian monitors individual performance on an annual basis, so any deficiencies, or trends in performance can be picked up at an early stage.

He said: “We have instigated a robust and watertight process to ensure an incident of this nature does not happen again.

“My biggest fear is that people just won’t come for breast screening because they fear their cancer won't be picked up.

"But that is just not the case.”

Plan to prevent screening blunders

EAST Lancashire Hospitals Trust has introduced a range of measures to meet the report's recommendations and prevent a repeat of the breast cancer screening blunders.

They include:

• The appointment of a new consultant radiographer to provide extra support to the breast screening unit, which last year moved from Accrington Victoria Hospital to a larger, refurbished unit at Burnley General Hospital.
• Putting in place revised incident reporting processes to ensure incidents in every trust department are ‘appropriately reported and acted upon’.
• Internal monitoring will identify departments reporting the fewest incidents, so that action can be taken to improve incident reporting.
• All staff, including senior managers and clinical leaders, will be reminded of trust policies and their obligation to report concerns about clinical performance.
• A new consultant appraisal protocol is being introduced with dedicated management and administrative resources to ensure it can be fully complied with at all times. A formal report on the new appraisals was given to the trust board in December and the first annual report of new consultant appraisals will be submitted to the board by the end of May.
• A risk management strategy is being developed across the East Lancashire Breast Screening Board to establish new ‘triggers and thresholds’ so that screening programmes can implement extra measures to ensure their services are performing to the required standard.