In the wake of Beverley Allitt and Harold Shipman's murder sprees, a string of recommendations followed to try to prevent further serial killers operating in the NHS.
But after Lucy Letby was allowed to kill seven babies, the probe into her crimes will examine if bosses learned anything from those horrific episodes.
The Thirlwall Inquiry, which opens tomorrow, will also urge the parents of her tiny victims to share their ordeals. Barrister Sir Robert Francis KC has been asked to examine how the NHS responded to Allitt and Shipman’s orgies of death.
Solicitor Tamlin Bolton, representing families of six Letby victims, said: “He has been asked to look back at things like Shipman, Beverley Allitt, the Mid-Staffs inquiry and consider the recommendations that followed.
“What the recommendations were, how they were meant to be implemented, whether they were implemented, and how they have assisted or changed NHS practice.
“The families will hopefully be asked for submissions and what they would like to see recommended to prevent this happening in the future.”
READ MORE: Family's fury as Lucy Letby's parents back campaigns to free killer nurse
Allitt, 55, was convicted of murdering four infants and attempting to kill three others at a Lincolnshire hospital in 1991. Like Letby, she used insulin in her attacks. Allitt is serving life.
GP Shipman was found guilty in 2000 of murdering 15 women with overdoses of morphine while working at Hyde, Gtr Manchester.
He was jailed for life but hanged himself in his cell at Wakefield jail in January 2004, aged 57. A probe revealed he murdered hundreds of patients since 1975.
Sir Robert carried out a five-year inquiry into up to 1,200 deaths due to poor care and chronic staff shortages at Mid-Staffordshire NHS Trust in 2010. That enshrined a “duty of candour” in the health service today.
But Ms Bolton said the families of Letby’s victims want Lady Thirlwall’s inquiry to be a “strong reminder” of that duty. She added: “A lot of the families I represent didn’t know their children had suffered collapses, they didn’t know the hospital had an increased death rate on that neonatal unit. They knew briefly there were investigations taking place but they didn’t really know why.”
Letby, 34, is serving 15 whole life sentences for murdering the sick tots and trying to kill seven others over 12 months from 2015 at the Countess of Chester Hospital where she worked as a neonatal nurse.
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