‘Cold’ Letby initially failed final student placement

Nicola Lightfoot, a nurse and then deputy ward manager of the children’s unit at Countess and Chester Hospital, was Letby’s mentor towards the end of her studies in 2011.

“I didn’t find a natural warmth exuding from her that I expect from a children’s nurse”

Nicola Lightfoot

However, Ms Lightfoot failed Letby because it “became apparent to [her] that Lucy didn’t have overall characteristics to be a successful registered nurse”.

Letby was able to complete a retrieval placement and later passed under a different mentor. She went on to murder seven babies and attempted to murder seven others while working as a neonatal nurse at Countess and Chester.

The Thirlwall Inquiry is now being held to explore how Letby was able to commit her crimes, and Ms Lightfoot appeared as a witness this week.

Explaining why she failed her, Ms Lightfoot said she thought that Letby’s communication skills and clinical knowledge were “lacking”.

In particular, she said she thought Letby struggled to pick up non-verbal signs of anxiety or distress from patients – a key skill for a children’s nurse.

She further added: “I found Lucy to be quite cold, I didn’t find a natural warmth exuding from her that I expect from a children’s nurse.

“I appreciate as a student you feel like you are being assessed all the time.  But I didn’t feel it was a natural characteristic that she showed.”

Lucy Letby

She also found that Letby struggled to retain and verbalise clinical information, the inquiry heard.

Her final comments on Letby’s report were: “At the moment Lucy is requiring much more support, prompting and supervision than I would expect at this stage to allow her to qualify as a competent practitioner.

“However, I strongly feel if Lucy continues to take on board feedback and continues to work on her weaker areas and develop her practice accordingly then this is achievable in the future.”

The inquiry was told how Letby had found Ms Lightfoot “intimidating” and how the pair had both agreed that Letby should have a different mentor for her retrieval placement.

After gaining her nursing PIN, Letby started working in the neonatal unit at Countess of Chester – which is next to but separate to the children’s unit where Ms Lightfoot worked.

The inquiry heard how Ms Lightfoot had overheard Letby making an “inappropriate” comment in June 2016 following the death of a triplet whose sibling had died the day before. Letby was later convicted of murdering them both.

As she was leaving the break room on the day of the loss of the second triplet, known as Child P, Ms Lightfoot passed Letby and heard her tell a colleague: “You never guess what just happened”, referring to the death.

“I felt it was inappropriate in light of what had happened,” Ms Lightfoot told the inquiry.

“The way she had said it seemed like she was talking about some exciting event or something, you know, that she had witnessed or seen on the unit.

“It wasn’t an appropriate response to the death of a child.”

She added: “The death of a child is distressing for everybody involved whether it’s expected or not.

“And it has a profound effect on the whole team looking after that child, and I have never since seen a response like that to a nurse involved in a patient’s passing.”

By the time Letby made the comment, she had carried out all seven of the murders for which she was later convicted, with Child P being the seventh victim.

Ms Lightfoot told the inquiry that Child P’s death was a moment that made her think that “perhaps there was something significant happening that I hadn’t been aware of”.

“It wasn’t an appropriate response to the death of a child”

Nicola Lightfoot

However, she was questioned by counsel to the inquiry Rachel Langdale KC as to why she did not raise concerns about Letby’s “inappropriate” comment.

Ms Langdale put it to Ms Lightfoot that Nurse ZC – who cannot be named for legal reasons – had approached her after the two triplets’ deaths and said: “Is it not concerning that she is involved and she is always there?”

While Ms Lightfoot said she did not recall this specific conversation, she added: “That is not the first time that I have heard Nurse ZC comment about Lucy.

“I had heard her and a couple of medical colleagues on a number of occasions discussing that Lucy must be involved.

“I felt it was quite malicious, it was gossip. It was, at that point, as far as I was aware, unsubstantiated.”

Around this time, briefings were held – which Ms Lightfoot was involved in – to tell staff that they should not be discussing deaths on the neonatal unit or Letby, and that if they did, “disciplinary measures might be considered”, the inquiry heard.

The counsel asked how such warnings to staff “sits by policies such as Freedom to Speak Up and speaking up about concerns”.

Ms Lightfoot responded: “I think there’s obviously always room to professionally challenge.

“I think if we have concerns we should escalate them and we have and I have been involved in escalating concerns previously, as I did when I had concerns about Lucy as a student.

“However, these have to be in a professional manner and the gossip and tittle-tattle and unsubstantiated talk such as that, is not usually part of a formal professional response to concerns.”

She maintained that, at the time of Child P’s death, she did not have enough information to warrant escalating a concern about Letby.

The inquiry continues.