Senior figures at Harrogate District Hospital have said they want to learn lessons from the Lucy Letby murders to prevent similar crimes from happening in Harrogate.
Letby is a former neonatal nurse who murdered seven infants and attempted to murder six others at the Countess of Chester Hospital between 2015 and 2016. She was sentenced to a whole life order last month.
Harrogate and District NHS Foundation Trust’s board met on Wednesday at the Crowne Plaza in Harrogate where the Letby case was top of the agenda.
Emma Nunez, director of nursing and Jacqueline Andrews, executive medical director, gave a presentation that outlined what procedures the hospital has in place to spot patterns of behaviour and how it listens to concerns from staff.
Ms Nunez said:
“It’s difficult to stand here and say we are completely assured that it couldn’t happen here, there’s not an organisation in the country that could say that. However, through our good governance and staff engagement we are in a very good place.”
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She added that the trust has spent time looking at its quality governance, which has included establishing an end-of-life mortality committee to review deaths and prioritising its safeguarding committee.
Ms Nunez said:
“Mortality review is something nationally we’ve been asked to look at and how we monitor unexpected deaths.”
Ms Andrews reassured the board that the hospital has the resources to identify anomalies in mortality data which could lead them to investigate potential crimes.
She said:
“We get a lot of mortality data, we have easily accessible data and we get a monthly alert on any mortality that’s an outlier. We do a deep dive into every one of them.”
Several doctors in Chester who worked alongside Letby said they tried to raise the alarm with hospital managers but were ignored.
Ms Nunez said the trust holds weekly talking sessions with staff where they can speak to managers.
She said she believes the trust fosters a culture where staff are able to voice concerns but she admitted there were still members of staff that were difficult to reach.
She said:
Similarities seen in Yorkshire to how Lucy Letby whistleblowers were treated“We have quite a flat structure where it’s not unusual to see staff openly have concerns with executive team. At back of mind, what about the ones who are more difficult to reach?
“That’s the question we need to ask ourselves, how do we reach those people?”
Similarities to how whistleblowers were treated when raising concerns about convicted child killer Lucy Letby have been seen across Yorkshire hospitals, it has been claimed.
At a York and Scarborough Teaching Hospitals NHS Foundation Trust board of directors meeting on Wednesday, September 27, concerns were raised about how comfortable staff are at raising issues of colleagues’ clinical practice.
NHS staff can raise issues through ‘speak-up guardians’ like York hospital’s Stefanie Greenwood, who presented a report to the board and told directors there are lessons to be learned from how complaints about Letby were treated prior to her arrest in July 2018.
Ms Greenwood said:
“Although it’s a very extreme case, there are some lessons we can learn.”
She added that cases like Letby’s show “the price that we pay if we don’t listen to our staff” and that “silence ultimately kills patients.”
Ms Greenwood said:
“Our staff currently do not feel safe to raise concerns.
“They fear reprisal and this can lead to unsafe patient care.”
She added:
“I have seen similarities in how the Letby case was handled and staff being shut down and told they need factual evidence.”
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Letby was jailed in August for a whole life term for murdering seven babies and trying to kill another six at Countess of Chester Hospital between 2015 and 2016.
Dawn Parkes, interim chief nurse at York and Scarborough’s hospital trust, said “any hint” of something wrong regarding patient care should be “explored,” even if there is no hard evidence of wrongdoing.
Jenny McAleese, a non-executive director at the trust, said:
“There’s not many concerns raised about safety and quality and I just wonder whether we just need to have a bit of a conversation about that and make sure people know that the freedom to speak guardian is there.”
She added:
“People are happy to raise concerns about people working while sick but there’s a bit of a reluctance to raise concerns about people’s clinical practice.”
Letby, 33, is only the third woman to receive a whole life order and is Britain’s most prolific child killer.
Many of her surviving victims have been left with life-altering conditions.
Dr Stephen Brearey told BBC Radio 4 in August that when he raised links between Letby’s constant presence during a spike in infant deaths at Chester hospital he was “put into mediation by senior managers.”
He said:
“I was put into mediation twice, once on fairly minor grounds and secondly with Lucy Letby herself and it seems to be a way of delaying action and investigating those concerns.”
Dr Brearey added that it is “a way of turning the things back to the clinician and suggesting that they’ve done something wrong.”
He added:
“It’s almost like weaponising that process.”
There has been an increase in concerns being raised across York and Scarborough hospitals in the last three years but these were mostly about ‘behaviours and relationships’ or ‘bullying and harassment.’
Simon Morritt, chief executive of York Teaching Hospital NHS Foundation Trust, said:
“How easy it is to raise concerns is really important to us.”