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The Letby case and Doctors’ non-clinical regulatory obligations

The recent Lucy Letby case made headlines across the world. Interest in her trial and subsequent sentencing has brought into focus not only Ms Letby’s actions, but also the actions of those people who were managing her and the unit she was working in. Recently, it was reported that Cheshire Police are investigating if corporate manslaughter charges can be laid in relation to the events that took place at the Countess of Chester Hospital.

In addition to their corporate responsibilities, doctors have to meet the non-clinical regulatory obligations set out by the GMC. This includes ensuring that the systems they oversee and the processes which they implement and supervise are fit for purpose, and are focused on delivering good patient care.

In this blog, we look at how a doctor can meet their non-clinical regulatory obligations.

Meeting the GMC standards in leadership and management

The GMC has produced specific guidance on the standards it expects doctors to meet in relation to leadership and management.

The introduction to the guidance is instructive as it lays out the GMC’s position:

“Being a good doctor means more than simply being a good clinician. In their day-to-day role doctors can provide leadership to their colleagues and vision for the organisations in which they work and for the profession as a whole. However, unless doctors are willing to contribute to improving the quality of services and to speak up when things are wrong, patient care is likely to suffer.

This guidance sets out the wider management and leadership responsibilities of doctors in the workplace, including:

  • responsibilities relating to employment issues
  • teaching and training
  • planning, using and managing resources
  • raising and acting on concerns
  • helping to develop and improve services.

The principles in this guidance apply to all doctors, whether they work directly with patients or have a formal management role…..

….You continue to have responsibility for the safety and wellbeing of patients when you perform non-clinical duties, including when you work as a manager. You are still accountable to the General Medical Council (GMC) for your decisions and actions, even if someone without medical training could perform your role.

The highlighted last sentence is significant because it makes clear that the GMC will investigate concerns about doctors even when they are operating in a purely managerial, non clinical role. The GMC frequently investigate cases involving drink driving, fraud, assault and similar, so investigating non clinical management is not as big a step as some might imagine.

Your obligation to raise and act on concerns

As stated above, one of the important responsibilities for doctors is “raising and acting on concerns”. One of the great tragedies of the Letby case is that it appears concerns may have been raised, but that these may not have been acted upon.

The GMC consider this to be such an important subject in its own right that they have produced separate guidance on this. The guidance essentially explains how to apply in practice the relevant principles in Good Medical Practice, which is of course the primary guidance for doctors.


The GMC guidance on raising concerns states the following:

“All doctors have a duty to raise concerns where they believe that patient safety or care is being compromised by the practice of colleagues or the systems, policies and procedures in the organisations in which they work. They must also encourage and support a culture in which staff can raise concerns openly and safely.”

The wording is clear that doctors are under a duty to raise concerns and it is not optional.

If you find yourself in a position where you have a concern, you should check your practice’s own policies and procedures and read the GMC guidance in full.

If you are worried that you are not being listened to, or of potential repercussions, then DR Solicitors can offer you practical advice on best practise. For the rare occasions when things do go wrong and you find yourself in front of a regulator, we have the experience to guide you through that process.

For more information about meeting your non-clinical regulatory obligations or for any other primary care related legal issues, please get in touch for a free, no obligation chat on 01483 511555 or via email info@drsolicitors.com