UK - Healthcare worker arrested on suspicion of murder/attempted murder of a number of babies, 2018

[JosieJo]

— An NHS source said Ms Letby was moved into administrative duties in late 2016

Does this not suggest that her name had been flagged up to some degree before police involved?

Chester hospital baby deaths: Nurse Lucy Letby arrested on suspicion of murdering eight babies

It could suggest literally anything. Was this after the report came out when the unit stopped taking babies born under a certain number of weeks? Perhaps if that was the case then the workload dropped off?

Also, it was suggested further back on this thread that "administrative duties" often meant that a person was seen as more senior and it was akin to getting a promotion?

It could also suggest (perhaps strongly) that she was in no way suspected of doing anything at all. Are we to believe that if the hospital were of the opinion that a staff member was having an undue influence on deaths that there would be any question as to whether they would let them anywhere near the premises until they had carried out a full investigation? I'm no expert but I doubt that any hospital which suspected one of it's employees of being a serial killer whilst at work would allow them to remain at work for a couple of years. If the fears turned out to be true and she'd managed to continue killing they'd be crucified. People may end up in prison because of it.

Being put on those duties suggests nothing as far as I can see. Nurses are put on different duties all the time.

I'd say if it quacks , swims and walks like a duck ..its likely a duck ...ive been an nhs nurse for 34years ...being moved to admin duties is not promotion...and as the unit was so understaffed ...even if downgraded to admissions she would still be needed to work as a nurse not admin ...maternity or children's wards would be the logical move in the unlikely event she was not needed in neonatal...not admin

 

[JosieJo]

It is clear from reading the RCPCH report that there were systemic failures within the neonatal unit. One of the many impacts of these was that child deaths and serious incidents were not subjected to timely and thorough review by the department. This is evidence of the culture of apathy, fear and cover up to which I refer. The culture is that if one raises concerns over working practices or leadership then you'll become a target for bullying and retribution.

Only when the the issues became known to senior hospital management months later and the data was analysed was the concern level raised and action taken by the hospital management. That the Chief Executive resigned in 2018 and then moved to a senior NHS role in another organisation is somewhat telling of the lack of leadership and responsibility.

The hospital only subjected itself to scrutiny because they had no other option, given the unexplained deaths and collapses. That they took place in a department that was grossly substandard and which would be revealed as such, was a case of taking it on the chin.

LL could quite easily be a convenient fall guy/girl for a failed system. If the evidence against her is not more than circumstantial and relies on hospital rotas/medical records to place her with the patient at given times/treatment interventions then I would certainly have grave reservations over the reliability and integrity of such evidence, given the time periods involved and the desire of others to avoid sanction for mismanagement and dangerous practice.

I'm not for a minute suggesting that rotas or her name appearing on documentation alone would be anywhere near enough ...just that that is obviously a factor we will likely see here

I truly do not get the "fall guy" theory ...the poor management has already been exposed

 

[JosieJo]

I'm approaching this in exactly the same way I have any case I've followed
The case passed the evidence threshold by cps ...this does not mean automatic guilt but imo there is evidence we just do not know it yet.

 

[Marantz4250b]

— An NHS source said Ms Letby was moved into administrative duties in late 2016

Does this not suggest that her name had been flagged up to some degree before police involved?

Chester hospital baby deaths: Nurse Lucy Letby arrested on suspicion of murdering eight babies


I'd say if it quacks , swims and walks like a duck ..its likely a duck ...ive been an nhs nurse for 34years ...being moved to admin duties is not promotion...and as the unit was so understaffed ...even if downgraded to admissions she would still be needed to work as a nurse not admin ...maternity or children's wards would be the logical move in the unlikely event she was not needed in neonatal...not admin

A lot more than stuff like her being placed on admin duties is needed to convince me that the admin duties were a result of her being suspected of being a serial killer.

I'm not claiming any experience of the NHS here but, to reiterate my previous point; are we to believe that someone who was suspected by management to be involved with suspicious deaths would simply be moved to different duties? She'd still have ample opportunity to access serious drugs (or indeed could have purloined some over a period of years) and ample access to vulnerable patients. I work in a very highly regulated industry and if one of my staff were even remotely suspected as having some type of abnormal or dangerous behaviour they'd be removed from the premises until they had been investigated.

 

[JosieJo]

A lot more than stuff like her being placed on admin duties is needed to convince me that the admin duties were a result of her being suspected of being a serial killer.

I'm not claiming any experience of the NHS here but, to reiterate my previous point; are we to believe that someone who was suspected by management to be involved with suspicious deaths would simply be moved to different duties? She'd still have ample opportunity to access serious drugs (or indeed could have purloined some over a period of years) and ample access to vulnerable patients. I work in a very highly regulated industry and if one of my staff were even remotely suspected as having some type of abnormal or dangerous behaviour they'd be removed from the premises until they had been investigated.

Obviously I'm not stating anything as concrete..my point was its an indicator that her name may have come to light quite early on
The NMC reports on her case explain why they may not automatically go for nursing suspension
Its common practice for nurses to be moved to non clinical roles during early investigation

 

[Whitehall 1212]

I have worked for the NHS for 34 years in nurse management for 20 years of that.
A big percentage of hospital departments across the country in all specialities would come out underfunded and understaffed ..if a review was made to the extent The Countess had.
Without hearing the evidence obviously we have no idea how this will go.

These are just some of my thoughts

The hospital has already put itself through massive scrutiny and been shown to be so ineffective that for some time the service had to be halted....im not really sure what is left to be covered up ?

For whatever reason LL was identified as a common factor in the deaths years before her arrest so I'd fully expect a lot of the evidence to show she cared for these babies and rotas and documentation brought her to the intention of the trust.

It is clear from reading the RCPCH report that there were systemic failings within the neonatal unit. One of the many impacts of these was that child deaths and serious incidents were not the subect of timely and thorough review by the department. This is indicative of the NHS culture of apathy, fear and cover up to which I refer. If one raises concerns over working practices or leadership then bullying and retribution are often the response.

Only when the the issues became known to senior hospital management, months later and the data analysed, was the concern level raised and action taken by the hospital management. That the Chief Executive resigned in 2018 and then moved to a senior NHS role in another organisation is somewhat telling of the lack of leadership and responsibility.

The hospital only subjected itself to scrutiny because they had no other option, given the unexplained deaths and collapses. Not to report could have resulted in staff and managers being investigated for attempting to pervert the course of justice if they believed that serious criminality had taken place. That the deaths and collapses took place in a department that was grossly substandard, which would find its way into the public domain, was a case of taking it on the chin.

LL could indeed be a convenient fall guy/girl for a failed system. If the evidence against her is no more than circumstantial and relies on hospital rotas/medical records to place her with the patient at given times/treatment interventions, then I would certainly have grave reservations over the reliability and integrity of such evidence, given the time periods involved and the desire of others to avoid sanction for mismanagement and dangerous practice.

 

[Whitehall 1212]

— An NHS source said Ms Letby was moved into administrative duties in late 2016

Does this not suggest that her name had been flagged up to some degree before police involved?

Chester hospital baby deaths: Nurse Lucy Letby arrested on suspicion of murdering eight babies

Not at all. I understand that others may also have been transferred to other duties. To draw the conclusion that being placed in a administrative role is directly associated to concerns over her conduct is somewhat premature (no pun intended). There are a multitude of reasons why such a move took place.

 

[Whitehall 1212]

A lot more than stuff like her being placed on admin duties is needed to convince me that the admin duties were a result of her being suspected of being a serial killer.

I'm not claiming any experience of the NHS here but, to reiterate my previous point; are we to believe that someone who was suspected by management to be involved with suspicious deaths would simply be moved to different duties? She'd still have ample opportunity to access serious drugs (or indeed could have purloined some over a period of years) and ample access to vulnerable patients. I work in a very highly regulated industry and if one of my staff were even remotely suspected as having some type of abnormal or dangerous behaviour they'd be removed from the premises until they had been investigated.

I would like to know what protocols existed for the management of drugs within the department and the authorities required. My understanding is that these have been tightened up over the years, although in a neonatal unit where nursing staff have a high degree of responsibility unrestricted access may have been a thing.

You make an interesting observation regarding theft of drugs over a period of years. This was obviously a line of enquiry with the detailed police searches of LL's home address and parents address. Now if specific restricted drugs were recovered during those searches, without good explanation for their possession, then that raises the suspicion somewhat.

 

[Marantz4250b]

Obviously I'm not stating anything as concrete..my point was its an indicator that her name may have come to light quite early on
The NMC reports on her case explain why they may not automatically go for nursing suspension
Its common practice for nurses to be moved to non clinical roles during early investigation

We aren't talking about legal suspension to practice by the governing body here though. We are talking about suspension from her employment (on pay) whilst she is investigated. Her license to practice was not suspended until after she was charged in November. If it is claimed that the hospital had concerns about her being involved in deaths and called the police in in 2016, after she had been moved to other duties, then is it really likely they they would continue to allow her access to the premises, with all the inherent risks that that entails, and not actually suspend her until a couple of years later until the time of her first arrest? I certainly wouldn't be allowing a suspected serial killer into close proximity of potentially harmful drugs and vulnerable patients.

 

[Whitehall 1212]

I'm not for a minute suggesting that rotas or her name appearing on documentation alone would be anywhere near enough ...just that that is obviously a factor we will likely see here

I truly do not get the "fall guy" theory ...the poor management has already been exposed

For the NHS, an individual staff member with covert nefarious intent harming patients is far less damaging to individual and corporate reputations/career prospects than staff of all grades overseeing and accepting working practices that may have been the primary cause of unnecessary deaths and collapses.

I am sure the culpability has a significant impact on the compensation element for the poor familes also!

 

[Marantz4250b]

I would like to know what protocols existed for the management of drugs within the department and the authorities required. My understanding is that these have been tightened up over the years, although in a neonatal unit where nursing staff have a high degree of responsibility unrestricted access may have been a thing.

You make an interesting observation regarding theft of drugs over a period of years. This was obviously a line of enquiry with the detailed police searches of LL's home address and parents address. Now if specific restricted drugs were recovered during those searches, without good explanation for their possession, then that raises the suspicion somewhat.

It most certainly does! Given that the police seemed to be conducting an extremely thorough investigation of the properties (which also included the neighbours property as they were on the flat roof there) it could be reasonably concluded that they were looking for very small items such as syringes, vials and suchlike.

However......and I'm going to play devils advocate again here.....although it would change the picture somewhat, and not look good at all, it is not, of itself, proof of involvement in murder. I recall reading that Rebecca Leighton was found to have been giving herself a "five fingered discount" from the drugs cabinet after her arrest for murdering patients and was subsequently proved entirely innocent of any murders. But, no, it would not look good. Again though, she really doesn't seem the type so I'd be surprised if they had found anything.

I have absolutely no proof of this at all but, and don't mean any disrespect to anyone by it - I suspect that if the police simultaneously raided the home of every nurse and doctor in the UK and conducted a search of said homes, we might be very surprised at the number of "interesting" items which turned up.

 

[JosieJo]

Not at all. I understand that others may also have been transferred to other duties. To draw the conclusion that being placed in a administrative role is directly associated to concerns over her conduct is somewhat premature (no pun intended). There are a multitude of reasons why such a move took place.

Has there been any information on these others being removed to admin duties?

Yet again ill repeat what I said earlier
Her being put in admin duties "may" indicate that her name cropped up initially..whilst enquiries were early

All we are dealing with at the moment is "may bes"

 

[JosieJo]

We aren't talking about legal suspension to practice by the governing body here though. We are talking about suspension from her employment (on pay) whilst she is investigated. Her license to practice was not suspended until after she was charged in November. If it is claimed that the hospital had concerns about her being involved in deaths and called the police in in 2016, after she had been moved to other duties, then is it really likely they they would continue to allow her access to the premises, with all the inherent risks that that entails, and not actually suspend her until a couple of years later until the time of her first arrest? I certainly wouldn't be allowing a suspected serial killer into close proximity of potentially harmful drugs and vulnerable patients.

I'm not suggesting they would keep her in admin duties if they seriously suspected she had murdered babies at that time
A move to admin may ...in theory..as an example...have been say due to drug errors picked up during the investigation...that as an example..is a common reason for nurses to go onto other non clinical duties.

Her name or errors of some description may have been picked up initially...not that she was a murderer

To be clear ...this is just an example of one possibility

 

[JosieJo]

For the NHS, an individual staff member with covert nefarious intent harming patients is far less damaging to individual and corporate reputations/career prospects than staff of all grades overseeing and accepting working practices that may have been the primary cause of unnecessary deaths and collapses.

I am sure the culpability has a significant impact on the compensation element for the poor familes also!

The NHS Trust a nurse works for covers their indemnity
Whether the trust or from an individual point of view compensation i would think comes from the same pot

 

[JosieJo]

I would like to know what protocols existed for the management of drugs within the department and the authorities required. My understanding is that these have been tightened up over the years, although in a neonatal unit where nursing staff have a high degree of responsibility unrestricted access may have been a thing.

You make an interesting observation regarding theft of drugs over a period of years. This was obviously a line of enquiry with the detailed police searches of LL's home address and parents address. Now if specific restricted drugs were recovered during those searches, without good explanation for their possession, then that raises the suspicion somewhat.

Most drugs are in locked cupboards that any registered nurse would have access to ..there are certain drugs classed as "controlled drugs" where they are logged in a book and 2 nurses or a nurse and a dr have to sign out (using the book)
Most drugs aren't "controlled" so would be very easy to remove from the cupboard unnoticed
Obviously it would depend on what drugs were involved.
Prescription is by a Dr or Advanced nurse practitioner but in theory any nurse could remove drugs from a cupboard and administer them undetected

 

[Whitehall 1212]

We aren't talking about legal suspension to practice by the governing body here though. We are talking about suspension from her employment (on pay) whilst she is investigated. Her license to practice was not suspended until after she was charged in November. If it is claimed that the hospital had concerns about her being involved in deaths and called the police in in 2016, after she had been moved to other duties, then is it really likely they they would continue to allow her access to the premises, with all the inherent risks that that entails, and not actually suspend her until a couple of years later until the time of her first arrest? I certainly wouldn't be allowing a suspected serial killer into close proximity of potentially harmful drugs and vulnerable patients.

Prior to the investigation becoming a criminal one it would have been difficult to justify suspending a member of staff.

The initial investigation by the hospital was to review the deaths and collapses to identify likely causes. They would no doubt have been exploring the clinical and patient data for explanations and similarities. I doubt if their first thought was one of deliberate harm by anyone. They also identified poor practices and deficiencies and called in the RCPCH to conduct an independent review of the service and unilaterally downgraded the neonatal service owing to the concerns.

If LL's patient involvement was a recurring theme and nothing more, then it would be prudent to relocate her in the interim to a role where she had no access to patients or involvement with the neonatal unit, staff or record systems. It may be that she was moved to an alternative role for an entirely different reason. It may be that LL was one of a number of staff to be re-located to other duties, whilst the internal investigation took place. In this was no one would be singled out as a person of concern or suspicion. The timelines are relevant and I am tempted to put one around my lounge just to get a better picture of it all

Once the police were called in and LL was identified as a suspect then there would be justification for her to be suspended. I know this first hand having investigated criminal conduct directly involving NHS organisations.

The police will be very circumspect in sharing the evidence they have or the direction of their investigation with the NHS, RCPCH, NMC or anyone else. Everything is very much on a need to know basis and criminal investigators play their cards very close to their chest.

Without evidence LL could not have her NMC registration suspended as there has to be a fair and equitable hearing. Once charges are proffered then the NMC don't need evidence to suspend registration as being charged with a criminal offence is sufficient in its own right.

 

[Marantz4250b]

Prior to the investigation becoming a criminal one it would have been difficult to justify suspending a member of staff.

The initial investigation by the hospital was to review the deaths and collapses to identify likely causes. They would no doubt have been exploring the clinical and patient data for explanations and similarities. I doubt if their first thought was one of deliberate harm by anyone. They also identified poor practices and deficiencies and called in the RCPCH to conduct an independent review of the service and unilaterally downgraded the neonatal service owing to the concerns.

If LL's patient involvement was a recurring theme and nothing more, then it would be prudent to relocate her in the interim to a role where she had no access to patients or involvement with the neonatal unit, staff or record systems. It may be that she was moved to an alternative role for an entirely different reason. It may be that LL was one of a number of staff to be re-located to other duties, whilst the internal investigation took place. In this was no one would be singled out as a person of concern or suspicion. The timelines are relevant and I am tempted to put one around my lounge just to get a better picture of it all

Once the police were called in and LL was identified as a suspect then there would be justification for her to be suspended. I know this first hand having investigated criminal conduct directly involving NHS organisations.

The police will be very circumspect in sharing the evidence they have or the direction of their investigation with the NHS, RCPCH, NMC or anyone else. Everything is very much on a need to know basis and criminal investigators play their cards very close to their chest.

Without evidence LL could not have her NMC registration suspended as there has to be a fair and equitable hearing. Once charges are proffered then the NMC don't need evidence to suspend registration as being charged with a criminal offence is sufficient in its own right.

Cheers, all excellent points.

 

[Bakers]

I would like to know what protocols existed for the management of drugs within the department and the authorities required. My understanding is that these have been tightened up over the years, although in a neonatal unit where nursing staff have a high degree of responsibility unrestricted access may have been a thing.

You make an interesting observation regarding theft of drugs over a period of years. This was obviously a line of enquiry with the detailed police searches of LL's home address and parents address. Now if specific restricted drugs were recovered during those searches, without good explanation for their possession, then that raises the suspicion somewhat.

If any thing was found during the search of her house,garden or anywhere else that was searched she would of been charged

 

[Whitehall 1212]

The NHS Trust a nurse works for covers their indemnity
Whether the trust or from an individual point of view compensation i would think comes from the same pot

Although NMC registration also includes indemnity insurance for the member. If there is cover elsewhere in addition to the employers liability then NHS Resolution will be looking to reduce or even nullify their payout.

A civil action against LL by the Countess of Chester Hospital following a criminal conviction may result in the NMC insurers paying out for Countess Chester Hopsital losses from compensation claims, reputational damage and other losses etc.

If the cause was purely down to systemic failures, staff shortages, poor reporting and clinical investigation then NHS Resolution will most likely be the sole payee.

 

[Whitehall 1212]

DBM