NHS clinicians who were sacked after blowing the whistle about avoidable patient deaths say they fear lessons from the Lucy Letby murder trial have not been learned and the case will make no difference to their own claims for unfair dismissal. They say hospital bosses are still more concerned about reputation than patient safety, despite what emerged in the Letby case about the tragic consequences of ignoring consultants who first raised suspicions about her killing babies. Two consultants and a junior doctor who were sacked at different hospitals after raising concerns about patient deaths are challenging their dismissals in the employment courts. They all predict that the public outcry over the way senior doctors were ignored on Letby will not help their cases despite a public pledge from NHS leaders of better treatment for NHS whistleblowers. Mansoor Foroughi, a consultant neurosurgeon, was sacked by University Hospital Sussex NHS trust (UHST) in December 2021 for allegedly acting in bad faith when he raised the alarm about 19 deaths and 23 cases of serious patient harm that he said had been covered up in the previous six years. Those deaths and at least 20 others are now being investigated by Sussex police after allegations of medical negligence. Foroughi, whose appeal against his dismissal is due to be held in the coming months, told the Guardian: “I don’t think mine or anyone’s chances of success has increased [after Letby], and only a change in the law will do that.” In his first public comments about his plight, he added: “The vast majority of punished employees cannot afford the legal costs involved for any attempt at justice and yet NHS hospital management can use vast amounts of taxpayers’ money to pay incentivised and misguided legal professionals to throw the kitchen sink at the whistleblower behind closed doors.” A spokesperson for the trust said it could not comment on issues about personnel. Usha Prasad, a consultant cardiologist, was dismissed by Epsom and St Helier hospitals trust. The trust said this was due to concerns over her capability and a breakdown in relations with colleagues; Prasad said these were not the real reasons. She too had raised patient safety concerns. These included failures she identified that led to the avoidable death in September 2018 of a 76-year-old man referred to as Mr P. The trust insists she was dismissed on competency grounds and not whistleblowing. Prasad disputes this. An employment tribunal in 2021 dismissed Prasad’s claims of discrimination, victimisation, harassment and whistleblowing detriment; a further tribunal will be held regarding her dismissal. She said that when the same disciplinary allegations were submitted to the General Medical Council (GMC), it found there was no case to answer. In documents submitted to a employment tribunal hearing about costs in the case, which was due to be held last week, Prasad claimed she was told to change her report on Mr P’s death to remove a recommendation to refer it to the coroner and the hospital regulator. The trust denies this. The documents cite the Letby case as highlighting the consequences of “ignoring or punishing those who raise concerns”. The trust has not had a chance to respond to that filing. Prasad said the way the trust treated her and the costs involve in challenging the employment courts represented a chilling deterrent to those considering raising safety concerns. She said: “I was subjected to dismissal and referral to the GMC. I was very pleased to be exonerated by the GMC following a thorough investigation.” A trust spokesperson said: “The employment tribunal heard a number of claims by Dr Prasad which they unanimously dismissed, and commented that some of them were ‘completely misconceived’. The employment tribunal will hold a further hearing to decide whether Dr Prasad should pay a contribution towards the trust’s costs.” It added: “We take patient safety concerns very seriously and encourage everyone who works at the trust to raise issues at every opportunity so we can make improvements to patient care.” Dr Chris Day has been fighting a long battle with Lewisham and Greenwich NHS trust (LGT) after he raised concerns as a junior doctor about understaffing. He claims he was subjected to a campaign to discredit him resulting in the deletion of his training number, forcing him out of a career. An appeal is due to be heard in November against an employment tribunal judgment last year that found the trust did not deliberately conceal evidence when hundreds of emails related to his case were deleted by a senior executive. Day is pessimistic about his chances. He said: “I have had 10 years of it in my own whistleblowing case and I fear nothing will change following Letby. Ten years on and £1m later, the NHS is still fighting me, who raised serious safety concerns about an intensive care unit in London linked to two avoidable deaths. “The Letby example is an extreme example of the consequences of the NHS’s poor speak-up culture where significant energy and public money is spent on ignoring or covering up difficult truths.” A spokesperson for LGT said Day’s concerns were taken seriously when they were first raised and it had taken action to ensure employees were “empowered to speak up and are heard when they do”. They added: “We have made efforts to support Dr Day with his career, via an intermediary, including offering to help him recommence his consultant training with the NHS. He hasn’t yet taken up this offer and has appealed against the most recent judgment in our favour, which unfortunately restricts us from commenting further on the details of his case.” Prof Philip Banfield, the chair of the British Medical Association’s UK council, said: “We cannot continue with a culture in the NHS that puts the blame on those who raise legitimate concerns and that hounds them out of a career that is their life’s work. Those who speak up with the sole aim of improving patient care and patient safety should be thanked, not ignored, pilloried or persecuted for fulfilling their professional duty.” This article was amended on 1 September 2023 to clarify the positions of Usha Prasad and Epsom and St Helier hospitals trust regarding her dismissal. And it is not the case that the dismissal was upheld by a 2021 employment tribunal which Prasad is now seeking to appeal; the 2021 tribunal dismissed Prasad’s claims of discrimination, victimisation, harassment and whistleblowing detriment, but a further tribunal will be held regarding her dismissal.