A report investigating how a senior radiologist missed breast cancer in 61 women has found he was subject to an internal, non-clinical investigation back in 2006 which damaged his "morale and attitude".

Dr Glenn Kelly headed the regional screening programme for 16 years until September 2008, but had not conducted full and complete assessment checks for up to nine years.

Dr Kelly – referred to as Dr X in the independent report by Frank Burns - misdiagnosed 20 women who were later told they had breast cancer.

Another 41 women had their cancer diagnosis delayed by incorrect screenings he carried out at Accrington Victoria Hospital between 2000 and 2006.

The report criticised the failure of East Lancashire Hospitals Trust to raise concerns, and pointed to a lack of effective appraisal.

A diagnostic error by Dr Kelly identified back in November 2007 had been regarded as "an isolated incident".

Trust bosses say there was "no tangible evidence" at that time of his practice being deficient. But staff are now fully aware of processes for reporting incidents and "near misses", even if apparently isolated.

Since 2001 - when consultant appraisals were introduced - Dr Kelly only had three formal appraisals, and records of only two of these were retained.

Mr Burns also found that while Dr Kelly was removed from screening assessment in December 2008, the decision was made without the knowledge or involvement of either the Trust chief executive or medical director - the latter not being aware that cancers had been missed until April 2009. This was a breach of Trust policy.

A statement explained: "Clinical leaders within the radiology department were reluctant to formalise the action they had taken against a respected colleague until laboratory results showed beyond doubt that Dr X had made errors. As soon as they received this confirmation, they informed the medical director. While to some extent understandable, this was a mistake."

Dr Kelly has not undertaken clinical work since April 2009 and is suspended from duty pending disciplinary proceedings.

NHS chiefs have said they ‘welcome’ the report, published last week, and apologised to all women affected.

They say they have fully complied with the recommendations, strengthening incident reporting and risk management strategies.

Trust medical director Rineke Schram said: "Systems and processes for consultant appraisal have now been significantly strengthened. More than 90 per cent of consultants have been appraised in the last year.

"The report confirms that the East Lancashire Breast Screening Unit is safe and fit for purpose, with dedicated and competent staff. It praises the current Director of Breast Screening, who has developed strong and robust clinical governance processes within the breast screening service."