We owe the families affected by Letby meaningful organisational change

On 21 August Lucy Letby, a neonatal nurse, was sentenced to life in prison for the murder of seven babies and the attempted murder of six others (doi:10.1136/bmj.p1931).1 The case has raised many questions for the NHS about the systemwide implications of these deaths: why were opportunities to stop her missed, why were staff’s concerns about Letby not sufficiently acted on, and what will it take to resolve some of the deep seated problems in the NHS’s organisational culture?Since 2015 there have been three separate inquiries into NHS maternity services: Morecambe Bay, Shrewsbury and Telford, and East Kent NHS trusts (doi:10.1136/bmj.h1221 doi:10.1136/bmj.m4797 doi:10.1136/bmj.o2520).234 A fourth into Nottingham NHS Trust is under way (doi:10.1136/bmj.p1636).5 These inquiries share common findings: lack of leadership and teamwork, poor workplace culture, inadequate staffing, and a failure to listen to and act on the concerns of staff, patients, and families (doi:10.1136/bmj.p1943).6 The Letby case also revealed…
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