Lucy Letby: Shuffling deckchairs will not work. By Roger Kline (23 January 2024)

Summary

In this BMJ Leader article, Roger Kline discusses the failings of the Countess of Chester NHS Boards in 2022 following the arrest of Lucy Letby. Roger highlights that this is not unique to the Counter of Chester:

• Reputation management that avoids timely decisive action is familiar to staff in many NHS organisations.
• Primacy of finance at a time of gross NHS under-resourcing has roots in Government policy and a national failure to challenge it.
• The failure of the Countess of Chester Board to be curious and create a culture where staff who raised concerns were seen as “gold dust” not troublemakers, is commonplace not unique.

Roger acknowledges that there are no simple solutions but says that the regulation for managers is a performative gesture unless accompanied by other measures. He suggests that we "Make patient safety the prime litmus test for all initiatives and 'stop the line' (from Board to ward) when it is not. Do not allow organisational reputation to ever influence decision making in response to concerns. Be relentlessly 'problem sensing' not “comforting seeking'”.