It’s been almost 2 years since we published our Delivering Real Choice report. We want to share what we’ve been doing in that time to support women who choose to have breast reconstruction surgery.
Our working group
In 2022, we set up a group with NHS healthcare professionals and a supporter with lived experience, to find a solution to the pressures facing breast reconstruction services. The group included clinicians from the Association of Breast Surgery (ABS) and the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS).
The group has been looking at examples of best practice and innovation, such as new ways of training surgeons, to make sure that people choosing breast reconstruction surgery get equal access to services. We’re excited to share what we’ve been doing behind the scenes.
Referral to treatment target
We know that many women wait a long time for reconstruction surgery, and we’re aiming to reduce that time. We encouraged NHS England to update their referral to treatment target so that people should not wait longer than 18 weeks from referral to treatment.
In February 2024, NHS England updated their target to include breast reconstruction. This means that once your surgeon says you are ready for your reconstruction, this should happen in the next 18 weeks.
Training consensus statement
Breast Cancer Now, ABS and BAPRAS produced a statement to address the need to train more NHS surgeons and specialist nurses in all types of breast reconstruction. The statement lays out a number of things we believe are important to help improve breast reconstruction. This includes increasing the number of surgical training places and developing a national training course for nurses.
We’re planning to share this statement with NHS England soon to encourage them to put this into practice.
Microsurgical Breast ‘Out of Programme Experience (OOPE)’
As part of the group’s ongoing work, 1 of the issues highlighted is a shortage of plastic surgeons able to perform breast reconstruction. As a result of this, we’re funding a 6-month OOPE for UK plastic surgical trainees to help train them in breast microsurgery.
The programme will provide focused training that helps trainees become NHS breast reconstruction consultants. This will give them the skills to train other plastic surgical trainees and the experience of working in a busy unit.
Patient leaflet
As well as working with a group of healthcare professionals, we also organised a supporter’s group. The group was made up of women with experiences of reconstruction. This group highlighted that patients often don’t know when they may have their reconstruction, or who best to contact when they have a question.
So, we produced a patient leaflet that includes information and links to help women through their reconstruction journey. People can also record phone numbers and useful contacts within the leaflet. The leaflet will be added to our website soon.
National payment scheme
The national payment scheme sets out the price paid to NHS Trusts for various activities. The group highlighted that the price set for breast reconstruction meant that trusts aren’t being paid appropriately for performing these types of surgeries.
Some of our group members worked with individuals across NHS England to encourage an increase in the price paid for reconstruction surgery. The increase was a welcome step in the right direction to pay surgeons the appropriate amount for the surgeries, but there’s still a need for a further increase.
The price is now set for the next financial year, but we’ll work to encourage another increase when the opportunity arises.
Reconstruction nursing toolkit
The work on the training consensus statement highlighted a need for more information sharing between breast reconstruction nurses and breast care nurses as part of their training and development. We’re exploring options to produce a breast reconstruction toolkit for breast care nurses to support shared learning.
We’re currently developing the toolkit and we’re hoping to share it with healthcare professionals soon.
What we’re doing now
We’ve produced a document that aims to update NHS England on the various pieces of work we’ve done. This document discusses the progress NHS England has made on the recommendations set out in the Delivering Real Choice report.
We have shared this with NHS England and have invited them to a meeting to discuss where we’re at, what still needs to be done, and who will be responsible for taking this work forward.
The future of breast reconstruction
We're asking NHS England to work with us to make sure all women can access the right type of reconstruction, at the right time for them. Read our report to learn more about how we can achieve this.