Williams Review of gross negligence manslaughter

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(Text previously at the manslaughter page has been moved here.)

On 6 February 2018 the Health and Social Care Secretary, Jeremy Hunt, announced a review, to be led by Professor Sir Norman Williams. This is known as the Williams Review of gross negligence manslaughter.

The terms of reference and other information about the review are available at the Professor Sir Norman Williams Review page at GOV.UK Web site..

The Williams review had a very short deadline ("The Review will aim to report in Spring 2018"[1]). The report was published on 11 June 2018 - see below.

It had been reported that it would confine its deliberations to level of knowledge among clinicians about “where and how the line is drawn between gross negligence manslaughter and negligence”; and to “lessons that need to be learned by the GMC and other regulators in how they deal with professionals following a criminal process for gross negligence manslaughter.”

The very narrow terms of the Williams review were criticised:

"From construction to aviation, safety conscious industries have tried to move away from a culture of blame, in which sanctioning individuals is, wrongly, seen as a useful deterrent, and towards a “just culture,” in which only reckless behaviour and wilful rule violations are punished.
"Many law and ethics scholars have argued that the law of gross negligence manslaughter, or the way in which it is used, is in need of an update to reflect this. But the terms of reference2 of the Williams review indicate that it will examine neither the law itself nor its use by the crown prosecution service and the courts. Instead it will consider only how government can make sure healthcare professionals know about the law, how (if at all) openness and transparency can be preserved in the current climate, and how professional regulators should act after a conviction.
"Why these narrow terms have been adopted is not clear. The department of justice has likely interfered to close down the health secretary’s broader ambitions.
"Missing the opportunity to review the law around gross negligence manslaughter is a great shame. Anyone with an interest in promoting patient safety should press the government to broaden the terms of the review to encompass the real issues."[2]



11 June 2018 Changes to be announced following the Williams review

The Williams Review's report is due (update - it has been published - see below.[3][4] An article on the BBC news website stated:

"New measures designed to improve patient safety and protect doctors and nurses when mistakes are made, are to be announced by the Health Secretary Jeremy Hunt.
"It comes after concerns were raised following the case of Dr Hadiza Bawa-Garba, who was struck off after the death of a six-year-old boy.
"Mr Hunt said staff should be able to learn from their mistakes.…
"Following a government review ordered by Mr Hunt, new measures are being introduced.
"These include:
  • "the investigation of every hospital death by a medical examiner or coroner
  • "data on doctors' performance will allow them to see how they compare to others to help them improve
  • "the regulator - the General Medical Council - will no longer be able to appeal against the findings of doctors' disciplinary hearings
"Professor Norman Williams who conducted the review said that "a clearer understanding" of when manslaughter charges should be brought in healthcare 'should lead to fewer criminal investigations' .
"Professor Williams said criminal investigation should be confined "to just those rare cases where an individual's performance is so 'truly exceptionally bad' that it requires a criminal sanction"."

As always, we'll need to see the actual changes introduced to see if they are likely to have the proposed effects.

11 June 2018 Williams report published

The full report has been published and is available here.[5] (Oddly, at the time of writing, and despite refreshing the cache on my computer, it does not appear to be mentioned at the official review website.)

Immediate responses to the Williams report

We cannot aspire to have anything approaching a complete list, but responses have so far been published by:

  • The BMA
  • The government
  • Campaigners

QuotationMarkLeft.png This is tantamount to criticising a pilot for crashing when the airline has failed to maintain the aircraft QuotationMarkRight.pngMcDonald and Vaughan, 2018, re Sellu

QuotationMarkLeft.png Her erasure has simply ‘achieved’ an own goal for the GMC QuotationMarkRight.pngMcDonald and Vaughan, 2018, re Bawa-Garba

Submissions to the Williams review

Submissions to date include the following.


  1. Department of Health. Williams Review into Gross Negligence Manslaughter in Healthcare: Terms of Reference. London: Department of Health, 2018(March); 1-2 (https://www.gov.uk/government/groups/professor-sir-norman-williams-review).
  2. Reynolds T. Narrow terms of reference mean that Jeremy Hunt’s review of gross negligence manslaughter will miss the point. BMJ 2018;361, DOI: 10.1136/bmj.k1721 (https://www.bmj.com/content/361/bmj.k1721). or full rapid response.
  3. BBC News. New measures to protect doctors after Bawa-Garba case. BBC News web site, 2018; Updated 11 Jun 2018; Accessed: 2018 (11 Jun): (https://www.bbc.co.uk/news/health-44413443).
  4. Bannerman L, Lay K. Doctors who kill will not be sacked for ‘honest mistakes’. The Times, 2018; Updated 11 Jun 2018; Accessed: 2018 (11 Jun): (https://www.thetimes.co.uk/article/doctors-who-kill-will-not-be-sacked-for-honest-mistakes-jvpnb2qg9).
  5. Williams N. Gross negligence manslaughter in healthcare: The report of a rapid policy review. London: Department of Health and Social Care, 2018(11 Jun); 1-61 (https://www.gov.uk/government/publications/williams-review-into-gross-negligence-manslaughter-in-healthcare).
  6. Hunt J. Professor Sir Norman Williams' review into gross negligence manslaughter in healthcare:Written statement - HCWS751. www.parliament.uk, 2018; Updated 11 Jun 2018; Accessed: 2018 (11 Jun): (https://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2018-06-11/HCWS751).
  7. Vaughan J. Jenny Vaughan: The Williams Review—a significant step forward for all. BMJ Blogs, 2018; Updated 21 Jun 2018; Accessed: 2018 (22 Jun): (https://blogs.bmj.com/bmj/2018/06/21/jenny-vaughan-the-williams-review-a-significant-step-forward-for-all/).
  8. McDonald P, Vaughan J. The aftermath of the Sellu case for law and the medical profession. RCS Bulletin 2018;100(5):207-9, DOI: 10.1308/rcsbull.2018.207 (https://publishing.rcseng.ac.uk/doi/10.1308/rcsbull.2018.207).
  9. BMA. BMA response to Sir Norman Williams Review. London: BMA, 2018(17 Apr); 1-13 (https://www.bma.org.uk/collective-voice/committees/medico-legal-committee/medical-manslaughter/bma-response-to-norman-williams-review). (pdf)
  10. Bradshaw P, Hanington L, Reynolds T. Evidence to the Professor Sir Norman Williams Review: Medical Protection Society (MPS), 2018(13 March 2018); (https://www.medicalprotection.org/uk/about-mps/our-policy-work/consultation-responses/consultation-responses/evidence-to-the-professor-sir-norman-williams-review)
  11. Barker I. Professor Sir Norman Williams Review into gross negligence manslaughter in healthcare: Medical Defence Union submission: MDU, 2018(27 March); (https://www.themdu.com/about-mdu/our-impact/our-impact-archive/mdu-urges-for-clearer-coroners-guidance-to-minimise-manslaughter-investigations).
  12. official Williams review web site
  13. General Medical Council (GMC). Williams Review into Gross Negligence Manslaughter in healthcare – GMC written submission: General Medical Council (GMC), 2018; (https://www.gmc-uk.org/news/news-archive/doctors-reflections-should-be-legally-protected).