Intended for healthcare professionals

Rapid response to:

Editor's Choice

We owe the families affected by Letby meaningful organisational change

BMJ 2023; 382 doi: (Published 31 August 2023) Cite this as: BMJ 2023;382:p1986

Rapid Response:

Re: We owe the families affected by Letby meaningful organisational change

Dear Editor

I welcome Juliet Dobson's call for organizational change in the light of the Lucy Letby case.

At the Countess of Chester Hospital, it was only after certain external expert input produced reports that it was accepted that serious concerns were justified. To help prevent the occurrence of future tragedies similar to that of Lucy Letby, external input and support should be a regular and inherent component of NHS work. I offer some specific suggestions –

1. Regular external accreditation of clinical services

2. At an individual level, regular external peer review of each other's work

3. Selection panels for senior NHS posts invariably have external representation. This should be obligatory and more substantive for disciplinary hearings and when whistleblowing concerns are being investigated.

4. Surgery has for a number of years had a national expert review panel to whom patient safety adverse events are reported so that lessons can be learned – CORESS ( Other medical disciplines should follow suit.

In addition to the above, we need a wide-ranging independent inquiry into whistleblowing in the NHS. The current Guardian system has clearly failed. Such an inquiry should hear from those who have repeatedly raised concerns and have suffered, so that lessons can be learned and so that they can be given support. We have a Petition calling for a public inquiry, and this is the Petition link...

Competing interests: No competing interests

16 September 2023
Narinder Kapur
Consultant Neuropsychologist
University College London
Torrington Place, London