Dozens of cancer patients were harmed by administrative failures at an NHS trust that left them without letters about their treatment and with test results that were never acted on, a review has found. The months-long audit of gynaecology patients under the care of consultant Dr Jim Wolfe at Salford Royal Hospital in Greater Manchester uncovered widespread breakdowns in follow-up care, leading to delays in diagnosis and treatment for conditions including cancer.
The review, launched by the Northern Care Alliance (NCA) NHS Trust in 2024, examined hundreds of patient cases linked to Dr Wolfe. It found that some women had not been sent letters about their care, while others had their results ignored. The trust’s own board papers, published in November, concluded that “patient harm was identified due to delays in diagnosis and treatment”. Although the trust has not confirmed the exact number of patients affected, a source indicated that more than 60 individuals were harmed, including those whose cancer diagnoses were delayed. No patients died as a result, sources said. Dr Wolfe, who is listed as a consultant in gynaecological oncology at the hospital, remains employed by the trust, which declined to comment on his status.
The administrative failures that caused the delays go well beyond a single consultant’s caseload. A separate NHS England review of NCA’s gynaecology services at Salford Royal, carried out in December 2024, identified a “significant backlog” of more than 2,000 letters — including test results and referrals — that had not been sent to GPs as required. This backlog meant some patients faced treatment delays of at least five months. The review also found that the unit was failing to meet national cancer waiting time standards: the Faster Diagnosis Standard, which aims for 75 per cent of patients to be diagnosed or have cancer ruled out within 28 days of referral, and the 62-day target for starting treatment, which sets a goal of 85 per cent. These failures were “mostly” attributed to workforce pressures.
Systemic failures behind the delays
The NHS England review painted a picture of a service in crisis. It warned that the gynaecology unit was “heavily” reliant on agency doctors, and that its ability to provide on-call consultants had been undermined by “significant sickness absence and suspension” among permanent staff. These workforce issues directly contributed to the administrative backlog and the resulting harm to patients. The reviewers did not examine the trust’s own audit of Dr Wolfe’s patients, but the findings of the two investigations are closely linked: both point to a system in which letters are not sent, results are not followed up, and patients are left waiting for care.
Staff across the department have been raising concerns about patient safety and workloads for months. Rebecca Long-Bailey, the Labour MP for Salford, told The Independent she had been contacted by clinicians and support staff who reported “unsafe workloads, rota gaps, cancelled clinics and a lack of transparency around decision-making”. She said staff felt “silenced” when raising concerns, and that patients had been affected by delays, including missed cancer diagnoses. One staff member described the department as “sort of neglected”, adding: “They don’t give us enough nurses, they don’t give us new consultants, they don’t really bother trying to improve our services at all. It comes to the point where you start asking for things, and they don’t listen to you; it gets quite disheartening.” Another source said: “Everything really fell apart… There has been a loss of moral compass and a sense of what’s safe.”
The trust has apologised for the “distress we’ve caused” and said all affected patients had been offered support and had a plan for ongoing treatment or care. Dr Rafik Bedair, NCA Chief Medical Officer, said the trust followed “all relevant NHS and regulatory policies and procedures” during the review and had been honest with patients about the issues identified. NHS England confirmed it was satisfied with the measures the trust had put in place to address the problems and reduce risk. The Greater Manchester Integrated Care Board will continue to monitor the trust’s progress.
The Care Quality Commission (CQC), the health watchdog, said it was aware of the concerns that triggered the 2024 review and sought assurances that any issues relating to individual clinical practice had been dealt with appropriately. In a subsequent development, the CQC issued a warning notice to Salford Royal Hospital in February 2026 after an inspection the previous September. That inspection found patients in the hospital’s surgical services — which include gynaecology — were left in pain, exposed to safeguarding risks, and reluctant to ask for help because of staffing shortages. The inspection identified 11 regulatory breaches, including failures in safeguarding, person-centred care, safe care and treatment, staffing levels, and management oversight. Many of those issues had been flagged in a previous inspection in December 2022. The CQC also noted that only 18.3 per cent of eligible staff had completed dementia awareness training over three years, and that hygiene standards were compromised, with bedpans and urine bottles left to accumulate in bathrooms.
The Northern Care Alliance has paid out nearly £4 million in gynaecology medical negligence claims between 2019 and 2024, involving 50 claims and incidents — the highest number among Greater Manchester NHS trusts. In a separate case, a report in August 2023 found that spinal surgeon John Bradley Williamson at Salford Royal caused “severe harm” to at least 20 patients through botched operations and poor record-keeping. Discussions have also taken place about relocating emergency gynaecological services from Salford Royal to The Royal Oldham Hospital, a move that has raised concerns about longer travel times for patients experiencing miscarriages or ectopic pregnancies. The trust has stated that no decision has been made and that all aspects of the patient journey are being considered.
