A BREAST screening service which serves south Cumbria and north Lancashire must change or it is 'unlikely' to be able to continue a safe service, inspectors have said.

A report carried out by Public Health England into the unit at the Royal Lancaster Infirmary says the working environment is 'extremely poor', there are quality issues that need to be addressed and there are 'serious concerns' about management arrangements and the lack of an audit culture' within the service.

The unit is operated by the University Hospitals of Morecambe Bay NHS Trust (UHMBT).

"This independent external review was requested by UHMBT and NHS England, as the breast screening commissioners, following receipt of allegations from two 'whistleblowers' regarding concerns of unsafe practice in the breast screening programme at UHMBT," the report says.

"Film reading and clinical practice at the assessment stage in the breast screening service provided by UHMBT is currently operating within national minimum standards, however the working environment is extremely poor and if it is not addressed urgently the service is unlikely to be able to continue to provide a safe service to the women of North Lancashire and South Cumbria."

The report recommends the service 'slow down' screening schedules to ease pressure, a review of managerial arrangements be 'urgently' carried out and two radiologists receive refresher training.

However, it also acknowledges that the trust has been addressing working environment issues through team building workshops.

The unit was also praised for film reading, which is meeting national standards with 'good' overall cancer detection rates.

The report also highlighted that assessment practice is meeting national minimal standards and an extensive review of cases found none where assessment was regarded as substandard.

"The report provides independent, expert assurance that the breast screening service is currently operating within national minimum standards, together with good overall cancer detection rates," said Jackie Daniel, chief executive of UHMBT.

"However it is also very clear that in order to maintain this level of performance a number of urgent actions must now be undertaken, particularly to change the culture and working environment for the staff involved in this service.

"Some of those changes are already well under way including external assistance with team working."