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Lucy Letby case sparks doctors’ petition for NHS watchdog to ensure ‘managers are held responsible’

One of the consultants who worked with Lucy Letby and warned bosses about the serial killer nurse is supporting calls for regulation of healthcare managers to improve accountability within the NHS.

Dr Ravi Jayaram, a consultant paediatrician at the Countess of Chester Hospital, repeatedly raised concerns about his former colleague, who was jailed for life without parole on Monday. However, he said he has been left “incensed” by senior NHS management staff who he believes have failed to “put their hands up and admit that they got it wrong” when concerns about Letby were initially raised by doctors.

Dr Jayaram has called for NHS bosses who ignored concerns about Letby to face corporate manslaughter charges, believing that some of her victims could have been saved if action had been taken sooner. He is now backing a petition asking for parliament to pass legislation to create a new watchdog for NHS managers as a direct result of the Letby case.

The petition seeks to create regulatory oversight of healthcare managers in the NHS with the support of The Doctors Association UK (DAUK), and urges an independent regulator to be formed to hold NHS managers accountable for decisions affecting patient safety.

Dr Jayaram said: “A corporate manslaughter charge against the Countess of Chester as an organisation might result in a large fine but this ultimately punishes the patients cared for there, whilst the individuals whose actions facilitated this situation face no sanctions and can continue to work on highly paid NHS executive posts.

“There needs to be a system in place so that top-level NHS managers are subject to scrutiny through an independent professional regulatory body just as frontline healthcare professionals are regulated.”

Most managers are dedicated professionals, but some are not held responsible when their decisions negatively impact care, DAUK said. The petition, launched by GP Dr Anup Singh, highlights the Letby case, where multiple consultants raised concerns early but subsequently had their concerns dismissed without merit. The petition aims for regulation letting patients and families refer complaints about managers.

DAUK believes that managerial regulation could improve care across the NHS and other healthcare providers. Its petition calls for the creation of new laws regulating healthcare managers via an independent body. The frontline lobbying group believes this will make managers more accountable for patient safety impacts from their decisions.

Dr Matt Kneale, DAUK co-chair, said: “We believe new accountability through regulation will improve NHS patient safety. Doctors and other healthcare professionals already answer to regulators if care quality drops — why do we not hold managers to the same standards when they control resources affecting care?

“Managers must make difficult decisions on whistleblowing concerns, but shouldn’t escape responsibility for unsafe practices or outright neglect of concerns. Regulation would help to ensure transparency and accountability for those with such responsibility.”

The Government has announced an independent inquiry into Letby’s crimes which will investigate whether NHS bosses could have done more to stop her. Dr Jayaram has called for the inquiry to be upgraded to a statutory footing, which would compel witnesses to come forward and give evidence on oath.

On Monday night, Health Secretary Steve Barclay said that he was “engaging” with the families of Lucy Letby’s victims over the inquiry into her crimes and that it was important the inquiry had their “full confidence”. He said the inquiry would examine issues including whistleblowing “and other actions related to the case”.

Mr Barclay added: “As the Prime Minister has said, we’ll ensure that the legal framework for that has the full confidence of the families affected and I’ll be engaging with them on that – whether that’s on a statutory or a non-statutory basis – to ensure that inquiry, looking at issues such as whistleblowers and other actions related to this case, are fully investigated.

“Clearly, there’s a whole range of questions that have been raised by the case, they need to be looked at fully through a detailed inquiry, we need to ensure that that inquiry has the full confidence of the families affected. That is why I’m engaging with those families about the right legal framework for that inquiry.

“It’s important that we get that set up in a way that has the full confidence of the families and it’s the families that I am absolutely focused on in ensuring that their voices are heard.”

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