NHSE reminds trusts not to appoint unfit directors, in wake of Letby conviction

In a letter sent hours after the verdict on Friday, NHSE’s chief executive Amanda Pritchard instructed NHS leaders and boards to “ensure proper implementation and oversight” of their whistleblowing processes (known as ”Freedom to Speak Up”), by making sure all staff know how to raise concerns.

It reads: ”We… wanted to take this opportunity to remind you of the importance of NHS leaders listening to the concerns of patients, families and staff, and following whistleblowing procedures, alongside good governance, particularly at trust level.”

In particular, the letter from senior NHSE directors said, lower-paid staff and those with “cultural barriers” should be supported to raise concerns, and whistleblowers should be treated well.

Neonatal nurse Letby was found guilty on seven counts of murder and seven counts of attempted murder. She denied the charges but was convicted by a jury after a 10-month trial at Manchester Crown Court.

Paediatric consultants at the Countess of Chester Hospital had persistently raised concerns about Ms Letby, and HSJ has seen documents which suggest executives believed the consultants had made unfair and unfounded allegations against her and questioned the doctors’ integrity.

NHSE’s letter, also signed by its chief operating officer, medical director and nursing director, also reminds local directors of the requirements of the “fit and proper person test”, which is meant to prevent unfit directors from moving to other NHS board roles. The letter says boards may not “appoint any individual as a board director unless they fully satisfy all FPP requirements – including that they have not been responsible for, been privy to, contributed to, or facilitated any serious misconduct or mismanagement (whether lawful or not)”.

“The CQC can take action against any organisation that fails to meet these obligations,” it adds.

Over the weekend there were renewed calls, including from the British Medical Association, for statutory regulation of NHS managers.

There are questions about the roles of CoCH’s former nursing director Alison Kelly, who is now an interim director of nursing for Salford, within the Northern Care Alliance, and of former chief executive Tony Chambers, who has held several interim roles since leaving CoCH, including as CEO of Barking, Havering and Redbridge University Hospitals and Queen Victoria Hospital.

The letter on Friday highlighted policy changes in recent years which may help to prevent similar events, including the introduction of medical examiners nationally in 2021, and the planned introducation this autumn — following delays — of a new “patient safety incident response framework”, ”representing a significant shift in the way we respond to patient safety incidents, with a sharper focus on data and understanding how incidents happen, engaging with families, and taking effective steps to improve”. 

The letter goes on: “The actions set out in this letter, along with our full co-operation with the independent inquiry to ensure every possible lesson is learned, will help us all make the NHS a safer place…

”Lucy Letby committed appalling crimes that were a terrible betrayal of the trust placed in her, and our thoughts are with all the families affected, who have suffered pain and anguish that few of us can imagine.”

Government has announced an independent but non-statutory inquiry into the failings. This weekend also saw calls, supported by the Conservative chair of the Commons health and social care committee, for it to become a statutory, judge led inquiry.