Breast Reconstruction - FOI Response Register

NHS Shetland do not perform breast reconstruction surgery.

Part A – Breast reconstruction pathways

1. a) Please indicate with an X the type of breast reconstruction surgery currently performed by your health board. Please leave the related box blank if you do not perform an indicated surgery.

b) If your health board does not perform immediate or delayed implant breast reconstruction surgery, please state why, which health board you refer your patients to have the surgery and provide detail on the pathway.

c) If your health board does not perform immediate or delayed free flap surgery, please state why, which health board you refer your patients to have the surgery and provide detail on the pathway.

Part B – Delayed reconstructive surgery backlog

a) During the Covid-19 pandemic (between March 2020 and April 2022) at any point did your health board stop performing immediate breast reconstruction? If yes, what date did you stop performing the surgeries and what date were the surgeries restarted?

b) During the Covid-19 pandemic (between March 2020 and April 2022) at any point did your health board stop performing delayed breast reconstruction? If yes, what date did you stop performing the surgeries and what date were the surgeries restarted?

3. a) Can you provide the number of immediate breast reconstruction procedures performed in your health board, the number of patients on the waiting list for immediate breast reconstruction surgery, as well as the average and longest waits for each year from April 2019 to March 2025?

b) Can you provide the number of delayed breast reconstruction procedures performed in your health board, the number of patients on the waiting lists for breast reconstruction surgery, as well as the average and longest waits each year from April 2019 to March 2025?

4. a) Please list the OPCS-4 clinical codes used to capture the data for question:

3a. Implant

3a. Free flap

3b. Implant

3b. Free Flap

b) How does your health board ensure that clinical coding (OPCS-4) and data capture reflects the breast reconstruction service provided, for example is a manual used to clarify the codes use?

Part C – Patient information and choice

5. Does your health board have oncoplastic MDTs to specifically look at breast reconstruction for each patient? If yes, does a plastic surgeon attend to provide expertise on free-flap reconstruction?
6. Does your health board provide patients with information about the different types of breast reconstruction available? If yes, please provide detail on your process and link any shared decision-making tools/patient information leaflets etc.
7. Does your health board currently have any restrictions in place for breast reconstruction surgery, such as patients BMI level, time limits on surgery, limits on the number or type of procedures, and reduction of breast surgery or plastic surgery lists. If so, please state what that restriction is and provide details of how long it has been in place.