If you were previously on the fence about Lucy Letby’s guilt, have the Thirlwall findings swayed you either way?

On the spike this came up

Not an Extreme Outlier: Statistical experts, including statistician Sir David Spiegelhalter and mathematics professor John O'Quigley, testified and concluded that the mortality rate at the Countess of Chester Hospital was only about 10% higher than the average for similar neonatal units.

A spike like there was in a unit like the Countess of Chester has been calculated as less than 1% probability of occurring by random chance, so no, they probably aren’t “harbouring murderers”.

This news article from before Lucy was a suspect states there was 13 unexplained deaths and staffing was an issue, makes you wonder what caused the unexplained deaths she wasn’t charged with.

It’s not ignoring that at all. There’s been 1 death since the unit was downgraded - 1 in total. These figures related to when the hospital was at the higher level 2 (copied from Thirlwell report):

1. 2010: 1 death; 422 admissions
2. 2011: 3 deaths; 514 admissions
3. 2012: 3 deaths; 556 admissions
4. 2013: 2 deaths; 460 admissions
5. 2014: 3 deaths; 557 admissions
6. In 2015, eight babies out of 468 admissions died on the neonatal unit.

Yes, those numbers are right. Three neonatal units a year will see a similar spike. A much bigger number of hospitals generally.

So are they all harbouring murderers?

What I find interesting is if you look at the stillbirth rates at Chester, they also spiked in 2015, now Lucy wasn’t a midwife so she would have been nowhere near those babies which suggests there was something else going on in that hospital at the time, but of course both things could be true. She’s a murderer AND the hospital was sub-standard

She’s an evil monster if they were murdered.

During my first pregnancy I was found to be positive for thalassemia. It’s really rare in people who are white British (which I am.) I just looked it up and the stats are about one in one thousand. It’s that difference between ‘there is a really low chance of this happening’ and ‘this happened so there must be an alternative explanation.’

Yes but it had been at level 2 for 10 years before being downgraded in 2016 and there’s been 1 death since.

The thirlwell report says:

In the years preceding 2015, the number of deaths on the neonatal unit at the Countess was consistently low. The number of deaths against the number of admissions each year was:

1. 2010: 1 death; 422 admissions
2. 2011: 3 deaths; 514 admissions
3. 2012: 3 deaths; 556 admissions
4. 2013: 2 deaths; 460 admissions
5. 2014: 3 deaths; 557 admissions

In 2015 eight babies out of 468 admissions died on the neonatal unit. In addition, two other babies born at the Countess were transferred to other hospitals, where they died.

She’s an evil monster.

From @Oftenaddled

Probably more important: the hospital took on more children who were particularly vulnerable specifically from April 2015 onwards. The indictment deaths started June 2015. Occupancy of the intensive care cots went up, and during these busiest months, the indictment babies died.

When linked with the downgrading of the unit after LL was removed is often overlooked and used as some sort of fait accompli as to she must hoave done whilst ignoring the massive change in curcumstances for the unit.

I imagine lots of murderers have good qualities and lots of innocent people are unpleasant and unattractive - I think it's pretty useless to try to work anything out from people's demeanour. Especially after you have arrested them and locked them up, when they are unlikely to be at their best!

Absolutely. They did actually count them in official stats and they are part of the spike that happened in 2015 -16. Like you I would have absolutely no doubt that there was a spike in deaths then - it is obvious. The question is what caused it.

Two things there: by random chance, we should see a similar spike at three or so neonatal units on the NHS every year. This doesn't indicate murder.

Probably more important: the hospital took on more children who were particularly vulnerable specifically from April 2015 onwards. The indictment deaths started June 2015. Occupancy of the intensive care cots went up, and during these busiest months, the indictment babies died.

When you look at the explanations the international expert panel offers for the deaths, they reflect a unit under that sort of pressure - delayed admissions, delayed procedures, delayed test results - alongside the panel's broader claim that the staff didn't have the skills and knowledge base to deal with such vulnerable children.

The spike definitely happened. But deaths dropping off after it reflect the fact that most children born at the unit were less vulnerable, and the most vulnerable were transferred out and died elsewhere. The numbers were definitely a huge cause for alarm whether you believe a murderer was involved or not. Unfortunately we see across the country that maternity and neonatal units struggle and children die unnecessarily without murder being committed.

But they didn’t count babies who died in other hospitals in pre 2015 deaths so the spike in deaths in 2015 is undeniable, the question is was LL responsible. I think she was

I think in any murder case we have to be absolutely certain first of all that a murder took place

Letby's case has a lot in common with Sally's; both involved bad statistics and overreaching expert witnesses.

Not related to the case, but Evans was one of Meadows' biggest supporters at the time of the scandal and has nothing but positive things to say about him.

Dennis Nilsen had a Dog he was very fond of and seemingly took very good care of, who would look after his dog was one of the only things he was concerned about when he was arrested.

I don't know if she is guilty or not but feel her conviction is unsafe. Whenever the case is in the news I'm reminded of the Sally Clarke case. Obviously very different but there's just something about the LL case that feels off.

The babies died at a lower rate after the hospital was - rightly - downgraded so they no longer took babies that fragile.

Or lying!

What I would imagine is that the atmosphere on the ward was pretty awful in 2018 - police investigation then arrest of someone who was a colleague and friend to many of the nurses, suggestion that babies had been murdered, possible fear suspicions would be extended. Someone might certainly pick up on tension and reserve in those circumstances!

The Thirlwall Inquiry proceeded on the assumption the conviction was correct, it wasn’t tasked with assessing Letby’s guilt. So there’s no reason why its findings would sway anyone either way on whether they believe Letby is innocent or guilty.

I wouldn’t go as far as saying Letby is innocent. But the evidence for trial was cherry picked (rotas where she wasn’t shift but children died were left out of evidence, insulin was used twice and on one of those occasions it was alleged she’d “primed” a bag to be delivered by a nurse on another shift to provide a plausible alibi, but there is no actual evidence of her spiking a bag like CCTV). The remaining evidence, whilst a large volume, was ultimately all circumstantial evidence. It was not sufficient, in my opinion, to prove beyond reasonable doubt (which is the criminal standard, as opposed to the balance of probabilities which is the civil standard) that she was guilty.

It is tragic for all the families involved, but I don’t think her trial proved her guilt beyond reasonable doubt. That isn’t the same as saying she’s innocent - she could have done a good job of covering her tracks. But our justice system requires a high standard for conviction which I don’t believe was met by the evidence.

Yes, and that poster has confirmed it was 2018.

Where? I have read most of it and haven't seen that yet. There is no way a unit without an ICU would schedule delivery of premature triplets (with one emergency ICU cot!), and the other children were all predictably in ICU in the first week of life before there was any question of an attack - and Chester now offered only emergency temporary ICU before transfer out.

Only question is whether Baby I might have been transferred back there after being born and treated elsewhere, which given her history of sudden deteriorations (also on occasions when Lucy Letby was not around or was at a different hospital, acknowledged by both sides at trial) is immensely unlikely.

No, at most one of them was (highly doubtful). Six of the babies were twins, triplets and / or born following obstetric complications (baby D). None of these would have been born in the downgraded unit.

The unit stopped admitting multiples and babies from complex pregnancies because it had only one ICU cot for emergencies, for use before transfer out. Gestational age wasn't the only criterion.

What should an intensive care nurse do in these circumstances?

In the first case, observe and call for help. This what she did.

In the second case, we are talking about blood around the mouth, from oral or gastric bleeding. Calling the doctor to see the blood and examine the child is again, what she did.

These were two extremely small premature neonates. You don't pick them up or conduct your own examination. You avoid touching and stressing them where possible. You can't see as a nurse whether a tube has dislodged internally or do anything to fix that. Remember that the doctors called to these two children had no criticism of Lucy Letby's conduct at the time - no nursing failure or problem identified, never mind deliberate harm. She was doing her job.

Definitely.