A British breast surgeon, who operated needlessly on patients, continued unchecked because of a culture of “avoidance and denial” in the institutions that should have stopped him, an inquiry has found.

Ian Paterson was sentenced to 15 years in prison in 2017 for carrying out unnecessary operations on 10 patients for personal gain.

His sentence was increased to 20 years owing to the seriousness of his crimes.

On Tuesday, an independent inquiry reported there had been an institutional failure to respond to “well-evidenced” complaints about his work.