Intended for healthcare professionals


Patient safety: listen to whistleblowers

BMJ 2023; 382 doi: (Published 29 August 2023) Cite this as: BMJ 2023;382:p1972
  1. Bill Kirkup, independent investigator1,
  2. James Titcombe, chief executive2
  1. 1Gateshead, UK
  2. 2Patient Safety Watch, London, UK
  1. Correspondence to: B Kirkup bkirkup{at}

Staff must be heard not threatened

The case of Lucy Letby, convicted of the murder of seven babies and attempted murder of another six, has caused shockwaves among the public and health communities alike. The first reaction was naturally dismay and disbelief that a member of a caring profession deliberately and repeatedly harmed helpless babies in her care. There are precedents, of course, in the actions of Shipman, Allitt, and others,123 but the rarity of such cases makes them all the more dreadful and incomprehensible.

Although the intentional harm underlying this gross breach of patient safety is rare, the subsequent failures to identify and acknowledge serious problems are sadly much more common. Doctors at the Countess of Chester Hospital rightly thought that they were seeing more deaths than expected, but they were unable to convince managers in charge of services that this was not simply the result of chance. When the pattern continued, not only did they have their concerns …

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