Case of Nurse Letby: Systems Failure in Safeguarding Patients

Abstract

The case of nurse Lucy Letby killing innocent babies in a neonatal unit, has yet again shaken the confidence of society in healthcare professionals and forced many professionals themselves to reflect on what impact this may have on their practice. Like in wider society, there are professionals who cause harm to others deliberately, and in some cases demonstrate attributes of serial killers. This is not new, and sadly is highly unlikely to be ever eradicated. What has shaken the healthcare professionals more than the murders of innocents, (if that was ever theoretically possible) is the failure of leadership to heed to concerns raised (whistleblowing) by a number of senior clinicians.  The actions of the leaders almost amounts to criminally protecting the perpetrator in this case. So it appears that established systems for raising concerns were blatantly defeated by the action of leaders. There is also an additional concern that the profile of the perpetrator may have played a role in how the leaders reacted to protect her. There are contrasts being drawn by analysts to cases where people with different personal attributes (protected characteristics such as colour, race, religion) may have played a significant part. This highlights the other elephant in the room, the differential treatment of people in society and in the healthcare professions based on their race of protected charateristics.  What can the profession and society learn from this and similar gruesome incidents? How should leadership accountability be established? What recourse do patients and professionals have to expect their concerns to be taken seriously before harm occurs? What is the implication of ‘Martha’s rule’ mean to healthcare?