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There is a lot still to come on the Lucy Letby case – a judge-led statutory inquiry, a retrial on one charge of attempted murder and her own appeal against the convictions last August.

So it is unwise to speculate too much about the case, and its NHS fallout.

But one of the trusts which employed the Countess of Chester Hospital’s former chief executive Tony Chambers has taken the step of checking his record when he led them.

This was to assure themselves that what Mr Chambers had been accused of by COCH medics – not responding to their safety concerns – was not a pattern of behaviour he brought with him to Barking, Havering and Redbridge University Hospitals Trust when he was appointed in January 2020.

The trust’s report, which goes before its board this week, found no concerns.

Indeed, it praised him as a “visible and dedicated” leader, taking the trust through the first two waves of covid.

But should he have been appointed to BHRT, given the whistleblowing concerns in Chester?

His appointment came after the start of the police investigation into Ms Letby but before charges were brought.

But the shadow cast by what were then just allegations was definitely known of in London. Indeed, the BHR report said Mr Chambers “spoke openly” about it at interview – a process which, the report adds, “was thorough and rigorous with regional and system representatives contributing”.

This is, at best, puzzling because in August, NHS England told the BBC that: “As regional director for London, Sir David Sloman was not aware of the events at the Countess of Chester when Tony Chambers was appointed.” 

That’s curious. It’s one thing to have decided it was reasonable to appoint Mr Chambers because (at that stage) no charges had been brought, nothing was proven, and the whistleblowing allegations were just allegations. It’s another thing to simply have not known.

Double trouble

An integrated care system has doubled its forecast deficit and is likely to miss its financial plan by £70m.

Shropshire, Telford and Wrekin ICS, which has had longstanding financial difficulties, had planned for a £57m deficit in 2023-24, but is now forecasting to report an overspend of £130m.

This represents around 14 per cent of its total funding – making it the largest deficit in England as a proportion.

Main reasons for the overspend cited by the ICS included use of escalation beds over winter, primarily related to the system’s only acute, Shrewsbury and Telford Hospital Trust, alongside industrial action and workforce costs.

Claire Skidmore, the integrated care board’s chief financial officer, said: “What we see in our forecast is borne out in our run rate, which is telling us that we are not going to get back to our planned position by year end. That is disappointing and frustrating for us as a system, because we want to make strong progress with our financial recovery journey.”

She added: “We know that 2024-25 will be a challenging year for which we will need to consider what we prioritise to help balance the demands of delivering improvements in quality, finance and performance.”

Also on today

In Recovery Watch, James Illman explains what “virtually eliminating” 78-week breaches really means, and in Comment, Andi Orlowski and colleagues say the NHS Federated Data Platform promises data integration, but a closer look reveals potential pitfalls in perpetuating biases.