A senior breast surgeon has failed in a High Court challenge to lift restrictions on his clinical practice, as a patient safety investigation at a North East England NHS trust remains ongoing.

Mr Amir Bhatti, the former clinical lead for breast cancer surgery at County Durham and Darlington NHS Foundation Trust, was barred from seeing patients in February 2025 following the launch of a wide-ranging review into the trust's breast cancer services. That restriction was later extended to a total ban on clinical activity after the trust raised concerns about his engagement with required retraining.

The investigation, which the trust initiated earlier this year, centres on a range of alleged clinical failures. These include cases in which cancers are said to have been missed during initial diagnostic assessments, and cases in which patients underwent mastectomies that may not have been necessary. The trust has not disclosed how many patients are under review.

Mr Bhatti brought his case to the High Court seeking reinstatement to clinical duties. The court dismissed the application. In its judgement, it found no serious issue with the trust's conduct and concluded that the restrictions represented a proportionate response to the active investigation. Mr Bhatti was ordered to pay the legal costs of the challenge. He remains employed by the trust on full pay while the internal review continues.

Steve Russell, the trust's chief executive, said the decision to maintain the restrictions had been informed directly by patient accounts gathered during the review. He said the breast surgery department had undergone significant changes over the past year and that clinical outcomes had improved as a result. "Our focus remains on providing safe, high-quality care for our communities," Mr Russell said.

Mr Bhatti has said he is cooperating with the investigations. He has not commented further while the process is under way.

The case raises questions that extend beyond the circumstances of a single clinician. Investigations into breast surgery services have surfaced at several NHS trusts in recent years, each involving similar categories of concern: delayed or missed diagnoses, questionable indications for surgery, and questions about clinical oversight. In such cases, trusts face the difficult task of acting quickly enough to protect patients while ensuring fairness to clinicians under review. Restrictions on practice, even when later found to be justified, carry consequences for the individual and for the services left to absorb their absence.

At County Durham and Darlington, the breast surgery unit has continued operating throughout the period of investigation, though the trust has not published details on how it has managed capacity or staffing in Mr Bhatti's absence. The review itself has not been given a completion date.

For patients caught up in any historical review of this kind, the wait for answers can be prolonged. Trusts are often cautious about communicating outcomes until internal processes are fully concluded, which can mean individuals wait months or longer to understand whether their treatment was appropriate. The trust has not indicated when it expects to write to affected patients, or how many have already been contacted.

The High Court ruling does not determine the outcome of the internal investigation. That remains a separate process, and its findings will be a matter for the trust and, depending on outcome, potentially the General Medical Council. Mr Bhatti's employment status and any longer-term consequences for his registration will follow from those conclusions, not from this judgement.

The trust has indicated it will continue to prioritise patient safety throughout the review.

‍