Responding to the Thirlwall inquiry report, the Chief Executive of MiP Jon Restell, said:

“The Thirlwall Inquiry has described deeply troubling failures at the Countess of Chester Hospital, with devastating consequences for babies and their families.

“One of the clearest lessons from the Inquiry is we must do more to create a culture where staff can raise concerns about patient safety – and where those concerns are acted on swiftly and properly.

“MiP members have highlighted this cultural problem for some time. In a 2023 survey following the Letby case, 42% of managers said the culture around raising concerns in their organisation was poor. Seniority and fear of reprisal were identified as the biggest barriers to staff raising concerns.

“Of the managers who told us they had raised a patient safety concern, only half felt it was safe to do so. This isn’t right.

“The survey also found that almost a third of managers did not believe their organisation had a clear process for dealing with concerns, while around a quarter did not feel confident managing concerns raised by their staff.

“The Thirlwall Inquiry reinforces the need to address these issues in general management and the clinical professions. Having policies and processes in place is important, but they work only if there is a culture of leadership and accountability around them.

“While supporting the principle of management regulation, few members think it will of itself do much to change culture. And, as many have pointed out, the key directors in the Letby case were covered by a professional regulator.

“All NHS staff need to know that they can speak up when something does not look right, without fear of being blamed or sidelined. Equally, managers and boards need the capacity, skills and confidence to listen to difficult messages, challenge assumptions and act when patient safety may be at risk.

“Managers have an important safety-critical role in creating that culture, and they need resources and stability to respond effectively. In an already undermanaged service, the NHS is busy stripping out even more management jobs, against the evidence and despite the public wanting better management.

“The NHS should use the Inquiry to strengthen how concerns are raised, escalated and acted upon, and to improve organisational culture across the system. That means building stronger relationships between clinical and management teams, strengthening accountability and raising professional standards.

“Getting this right is essential to protecting patients and keeping public confidence in the NHS.”