Hughes LJ, Mitchell M, Johnston AN. ‘Failure to fail’ in nursing—A catch phrase or a real issue? A systematic integrative literature review. Nurse Educ Pract. 2016; 20:54-63

Nursing and Midwifery Council. The Code. 2015. (accessed 31 August 2023)

The Shipman Inquiry. 2002 First Report. Volume One. Death disguised. Chair: Dame Janet Smith. 2002. (accessed 31 August 2023)

The Shipman Inquiry. Third Report. Death certification and the investigation of deaths by coroners. Chair: Dame Janet Smith. 2003.

The Shipman Inquiry. Fourth Report. The Regulation of controlled drugs in the community. Command Paper. Cm 6249. Chair: Dame Janet Smith. 2004a. (accessed 31 August 2023)

The Shipman Inquiry. Safeguarding patients: lessons from the past—proposals for the future. Command Paper. Cm 6394. 2004b. (accessed 31 August 2023)

UK Government. Government orders independent inquiry following Lucy Letby verdict. 2023a. (accessed 31 August 2023)

Maverick practitioners who do harm

02 October 2023
Volume 28 · Issue 10

The overwhelming majority of healthcare practitioners go to work to give their best to those receiving their care despite sometimes testing situations due to limited resources or other constraints. However, the Letby criminal case has challenged us to consider that there may be a healthcare practitioner somewhere in the NHS whose motives are malevolent and their whole practice might be based on deception. Beverly Allitt and Harold Shipman were similarly convicted of murdering vulnerable patients under their care.

It is clear that it is not easy to identify and secure convictions of malevolent practitioners because much healthcare practice takes place hidden from view, even within hospital settings. A rise in hospital mortality may be explained away as just a random statistical variation which occurs occasionally with A ‘blip’ of increased mortality in patients. This may be due to a rise in the number of patients who had entered hospitals being particularly sick and succumbing to their conditions despite the best efforts of those involved in their care. Hospital patients receive care from multiple doctors and nurses and so, working out if the deaths are associated with a particular practitioner is hugely challenging. Even then, having identified a possible association between an individual practitioner and a patient death to secure a prosecution, the act of commission has first to be identified, and then proven beyond reasonable doubt in a jury trial to meet the legal benchmark for a criminal conviction.

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