Paediatrician who raised alarm over Letby joins BMA in calling for regulation of NHS executives

Paediatrician who first raised the alarm about neonatal nurse Lucy Letby, who killed seven babies in her care, has joined calls for NHS Trust executives to be regulated in the same way as doctors.

Lead paediatrician at The Countess of Chester Hospital neonatal unit, where Letby worked, Stephen Breary, said that the behaviour and accountability of senior officials within the health service “absolutely” needed to be regulated, after clinicians’ concerns about her were “turned on the head.”

Dr Brearey, who first carried out an urgent review into the nurse who was sentenced to a whole-life term for the murders, said: “Doctors and nurses all have the regulatory bodies that we have to answer to and quite often we’ll see senior managers who have no apparent accountability for what they do in our trusts and then move to other trusts.

“You worry about their future actions and there doesn’t seem to be any system to make them accountable.”

Senior doctors first reported Letby’s link to unusual deaths and collapses to executives on 2 July 2015, after three babies died and another suffered a near-fatal deterioration in just two weeks the previous month.

Several consultant paediatricians raised the alarm a number of times during the next year as the number of suspicious incidents grew and Letby was found to be present at all of them.

However, executives failed to launch a formal investigation until July 2016, more than a year after the link with Letby had first been raised. She was removed from the unit that month but the police were not contacted until May 2017.

Meanwhile ‘doctors’ union’ the British Medical Association (BMA) has also called for NHS managers to be held accountable for hospital failures through a new regulation system.

Writing on the BMA website, BMA council chair, Phil Banfield, says: “As doctors, we are obliged to report concerns when we identify risks to patient safety, yet there is a sense felt by many of my colleagues that in doing so, they face resentment and are seen as the problematic, questioning ones who just think they know best.

“Too often our voices are stifled because truths are uncomfortable or may carry potential reputational damage for an individual, an organisation – or a government.”

Phil Banfield says that, ironically, the most damage comes from not listening to these concerns, the sometimes-fatal consequences of delayed investigations and late interventions. The lack of senior doctors on executive and board positions in NHS organisations was just one example of how valuable independent representation on a clinical level is absent.

Referring to the Letby trial, he adds: “This case raises serious questions about how healthcare providers are governed. It is unacceptable that there was no way for senior doctors to raise serious concerns directly with non-executive directors.

“For years, the BMA has campaigned for a change in the culture of blame and suspicion within the NHS and has long called for non-clinical managers to be regulated. We need a regulatory mechanism for holding senior non-clinical managers to account, in line with the way clinical staff are held to account by our regulator.”

After the trial, Dr Dewi Evans, 74, a paediatrician and National Crime Agency-accredited expert, who gave evidence in court about each of Letby’s 13 victims, said that three murders could have been prevented if hospital bosses had acted more urgently on the concerns of medical staff.

He said: “Failing to act was grossly irresponsible – let’s make it as clear as that. We are talking about a serious emergency. It’s grossly irresponsible and, quite frankly, unbelievable [that they failed to act sooner].”