THERE is an “outside chance” that a Lucy Letby-style serial killer nurse is working at the BRI, Bristol Children’s Hospital or Weston General, bosses have warned.

University Hospitals Bristol & Weston NHS Trust (UHBW) chief executive Eugine Yafele said that although there were many routes for patients and staff to raise concerns and that medical data and other warning signs were regularly analysed, “the best process in the world would not have weeded out” Letby, who killed seven babies in a Chester hospital.

He told a UHBW board meeting that the organisation could not be complacent.

Members were discussing their response to NHS England which wrote to all health authorities and hospital trusts with five requirements to ensure effective safeguards are in place following neonatal nurse Letby’s conviction for murdering seven infants and attempting to murder six more.

Prof Yafele said: “I was shocked and appalled to learn about Lucy Letby and the actions that came out when the verdict was delivered

“This was somebody who was a nurse but before she was a nurse she was a serial killer and mass murderer.”

He said a number of improvements had been made at hospitals since the deaths in 2015 and 2016, including a whistleblowing programme called Freedom to Speak Up and better use of data and incident reporting.

Weston Mercury: Weston General Hospital.Weston General Hospital. (Image: Google Street View)

But Prof Yafele said: “That should not make us complacent because the process will only take us so far.

“The best process in the world would not have weeded out a serial killer because they are charming, endearing and really lovely to be around but they are also people who kill.

“We wouldn’t want to second guess the case review but it brings into sharp focus that as organisations we must have open, compassionate, inclusive cultures where patient safety is not just the job of the nurses, doctors, therapists, it’s everybody’s business.

“We will continue to invest in our leaders ensuring they too develop the ability to be more compassionate.

“The challenge for us is how we separate the signal from the noise because a number of things have come up in medical organisations that make us think ‘how do we step back and look at what’s going on?’”

He said the key was to bring together all the indicators that something was not right because serious safety issues came with several warning signs at the same time, such as the number of complaints and safeguarding issues raised.

“We employ nearly 15,000 staff and we would be representative of the wider community and society, so there is an outside chance that we will have people who intend to cause harm within our organisation,” Prof Yafele said.

“The combination of the culture we are trying to set, some of the processes and procedures that we have and the insights that we get on patients, carers and those around us mean we are more likely to spot any harm or people who intend to cause harm within the organisation.

“More than anything we are determined to be curious, to keep an open mind and keep learning.

“That’s not to suggest that we  look at our colleagues with suspicion but to realise that these things can happen in any medical environment.

“But we are in a good place and absolutely determined to use everything in our arsenal to keep our patients safe and take learning not just from this incident but from others and reassure ourselves that we do everything everyday across all our patient areas to keep our patients safe.”

A report to the board outlining UHBW’s response to NHS England said: “The trust has a range of mechanisms in place to support staff and patients to have a voice.”

But it said: “Further work is required to ensure that all staff understand the different routes to speak up and to ensure they have confidence that the trust will listen and act promptly.

“Continued work is required to understand and address the cultural barriers in existence across the trust which stop some staff speaking up.”

Members heard these barriers included hierarchies in medical professions that meant lower paid staff may be less confident to raise concerns.

Board chair Jayne Mee told the meeting on Tuesday, September 12: “We have all these routes for speaking up but we don’t capture all the themes and how they link together.”

Chief medical officer Stuart Walker told the meeting that alarm bells should have rung for the board in charge of the Countess of Chester Hospital because infant death rates had “risen through the roof”, so “speaking up” was just one part of the safety net alongside data.