Doctors’ campaign against Letby was challenged by nurses
Nurses wanted Lucy Letby to remain on the neonatal unit where she worked, while consultants believed she should be removed, as suspicions grew about her involvement in unexplained baby deaths, an inquiry has heard.
The Thirlwall Inquiry, which is examining how Letby was able to harm babies in her care at the Countess of Chester Hospital, commenced this week.
“The clinicians became more vociferous about her being removed, whilst the nurses wanted her to remain on her unit”
Ian Harvey
Rachel Langdale KC, counsel to the inquiry, delivered her opening statements yesterday. As part of this, she discussed the way senior managers at the hospital reacted to the concerns around the former neonatal nurse.
Letby is serving multiple whole-life prison sentences for the murder of seven babies and attempted murder of seven others between June 2015 and June 2016 at the Countess of Chester Hospital.
The inquiry heard yesterday that there were several missed opportunities to stop Letby from murdering and harming babies, with warnings by consultants ignored.
Ms Langdale told the inquiry that senior paediatricians on the unit had raised concerns about Letby’s presence on the unit and her potential link to the unexplained incidents involving babies.
She said the number of deaths were “exceptional”, occurring between midnight and 4am and the “only common theme was Letby being on duty”.
Despite this pattern, executives at the hospital insisted that there was insufficient evidence to remove Letby from the neonatal unit. Instead, they moved her from night shifts to day shifts.
Ms Langdale read a statement from Ian Harvey, the former Countess of Chester Hospital medical director, about the mixed reaction on the neonatal unit after concerns were raised about Letby’s involvement in the baby deaths.
Mr Harvey had described a “difficult balance” to strike surrounding Letby remaining on the unit.
He noted that, at this stage, it was difficult to understand what was causing infant mortality rates to increase and “whether it might relate to [Letby’s] competency or performance or was completely unrelated to her practice”.
Mr Harvey’s statement said: “My general recollection of the days that followed is that the clinicians became more vociferous about her being removed, whilst the nurses wanted her to remain on her unit.”
It took the unexpected deaths of two triplets, child O and child P, in June 2016 for Letby to be removed from the ward.
These two deaths “catapulted the issue of Letby and neonatal mortality to the top of the executive team agenda”, Ms Langdale said.
In July 2016, the executive team at the Countess of Chester Hospital stopped Letby from returning to patient-facing work, which was supposed to be temporary.
However, Ms Langdale noted that the head of nursing at the trust, Karen Rees, had described this decision as “wrong and immoral”.
Ms Rees declared last year, following the trial, that she was never given enough information to suspend Letby from practice.
The inquiry heard yesterday that Ms Rees believed concerns about Letby were based on a “gut feeling” from senior paediatricians and not evidence.
Ms Rees had said in an email: “This allegation against Letby is massive and if this clinician and anyone is of this belief then why have the police not been called?”
Further pushback from consultants prevented Letby from ever working on the neonatal ward again before her arrest.
Ms Langdale said it was thanks to the “tenacious lobbying of the consultants” that her return to work was never authorised.
She added that, without their persistency, it was likely that she would have “been permitted to return to dealing with babies”.
Separately, Ms Langdale noted that Letby’s nursing registration was “not subject to any restriction or suspension until she was charged with murder”.
The Nursing and Midwifery Council (NMC), which is a core participant to the inquiry, is set to be probed on its response to concerns raised about Letby.
The inquiry heard that former Countess of Chester chief nurse Alison Kelly contacted the NMC about allegations against Letby but made no formal referral to the regulator.
However, Ms Kelly did tell the NMC that some clinicians were concerned that Letby “may present a serious risk to public safety”, the inquiry heard.
Ms Langdale added: “Although the trust had power to impose suspension, it had no power to stop her from seeking patient-facing work elsewhere.
“Only the NMC has that power.”
The opening statements for the core participants to the Thirlwall Inquiry are expected to begin on Thursday 12 September.
