Senior NHS bosses should be regulated to improve patient safety, Letby inquiry told

By Kim Pilling, Reporter7th January 2025News EnglandCare Standards, Hospitals, News England, NHS, Registration / Regulation, Serious / Significant Case Review / Inquest

Regulation of senior hospital managers could improve patient safety, the public inquiry over the crimes of nurse Lucy Letby has heard.

Letby, 35, was moved to clerical duties in July 2016 after consultant paediatricians on the neonatal unit at the Countess of Chester Hospital flagged up their increasing worries that she may be deliberately harming babies.

The Thirlwall Inquiry has heard that hospital bosses opted to commission a series of reviews into the increased mortality on the unit in 2015 and 2016, with plans to return Letby to the unit shortly before Cheshire Constabulary was asked in May 2017 to investigate the events.

Giving evidence on Tuesday, Dr Alan Clamp (pictured), chief executive of the Professional Standards Authority (PSA), told inquiry chairwoman Lady Justice Thirlwall that senior NHS managers should be regulated – a recommendation that was made in the 2001 Bristol Royal Infirmary Inquiry report into failings in paediatric heart surgery in the 1980s and 1990s.

The PSA oversees the functions of the 10 regulators of people who work in health and social care such as doctors, nurses, pharmacists, dentists and social workers.

Dr Clamp said: “The advantage of introducing regulation in any form for NHS managers would be the potential to prevent or reduce harm to patients.

“This would be achieved through better management of the risks that arise to patients through the work of managers and its impact on care.

“Steps should be taken to enhance the professional development and accountability of NHS managers.

“We need to move forward now after 24 years since the Bristol Inquiry has shown us that whatever we put in place still needs improvement.”

The NHS recently produced a consultation document which is seeking views on the regulation of managers, including whether those who have conducted serious misconduct should be barred and whether there should be a professional register of managers.

It asks about the types of managers that should be regulated – from executive directors and chairpersons down to team managers working within the service – and whether these regulations should also apply to other managers not in direct employment of the NHS.

The document also asks for views on whether or not there should be education or qualification standards for managers.

Letby, from Hereford, is serving 15 whole-life orders after she was convicted at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims, between June 2015 and June 2016.

The findings of the Thirlwall Inquiry are expected to be published in the autumn.