Lucy Letby - what's happening

[Viviennemary]

In the last few days I've heard conflicting news stories. One an ex coroner saying she is innocent. And another piece of news saying the Cheshire police want to charge her with more crimes believed to have been carried out at two other hospitals she worked at.

No evidence other than the consultants’ own testimony, which says that they raised concern about Letby with Alison Kelley (amongst others) in October 2015. So yes, one word against another, although not hard to see why the hospital management would have an interest in concealing the truth about this.

However, even on your timeline there is evidence that there were significant concerns by Feb 2016, so that is still much longer than a week that she was able to stay on the unit committing harm.

Tricky. Neonatal wards are dark, mothers are doing skin to skin time or establishing breastfeeding, there are a lot of camera angles to cover, medicines are currently prepared away from the bedside usually, and preserving that amount of data for long would be a huge expense.

I do think CCTV would have proved parts of the prosecution's claims against Letby false if it had been there. So if you could get around all of those problems it would have some uses. But I suspect you'd save more lives by far putting your money somewhere else.

Anyway, if a system like yours existed, I'm sure it could be used as part of any wider enquiry, but they would need to be looking at notes, records and test results too.

Yes - with the consultants leading, the hospital undertook a review of nursing care at that point, and found no problems with Letby. Nobody was calling for her to be suspended from the ward at that point.

Pathologists had explained all but one of the deaths, with natural causes that line up well with the recent expert reports. One was unexplained, awaiting a coroner's inquest - and there are dozens of deaths in that category for infants every year. It's been explained since then too, of course.

So why would they have suspended Letby or contacted police at that point? When consultants demanded it, they did it - but still without any reason except that demand.

The accusations of deliberate harm came later. The possibility of incompetence was investigated and ruled out. What action should the managers have taken against Letby at that point?

Oh of course, notes and records along with test results are important. I just meant CCTV should be used for protection. There needs to be policies made for this and then with safeguarding. Only trained professionals should have access to the CCTV. Then, these recordings should be provided to the police when required.

If they can get around all the issues I've listed, I'd have no problem with that, but I would prioritise an external team of independent medical investigators like Phil Hammond suggests (and by all means let them liaise with police and coroner as a matter of course).

One of the problems you see with the Letby case is that they ran out of options to investigate while there were still medical questions to ask. If you think Letby was a murderer and the police should have been called sooner, that's okay in this case, but let's consider that other hospitals have similar spikes without murderers. A clear, compulsory process bringing in independent investigators would surely be better than hospitals flailing around trying to find individuals to take on work, and taking most of a year to do it in Chester's case.

Preventing murders (which are very rare in hospitals) is just a tiny part of the problem of preventing unnecessary deaths. And of course CCTV if usable - I have doubts - would pick up mistakes, negligence and symptoms not previously noticed - not just murder.

Stephen Brearey emailed Alison Kelly and Ian Harvey to request an urgent meeting about Letby in Feb 16 and also emailed Eirian Powell in very early March 16 along the same lines. Meeting didn’t happen until May 16.

It’s kind of irrelevant what the pathologists had concluded at that point as none of the post mortems had been carried out forensically with a view to looking for deliberate harm. Any medical director or director of nursing would be fully aware of the distinction and this being an issue. They would also have known that internal investigation of these sorts of suspicions/allegations was completely inappropriate.

And the onus should not have been on the consultants to call for her to be removed. Instead they should have been able to trust that once escalated the situation would be dealt with appropriately by hospital management. It really wasn’t.

No trace has been found of that email - and only that consultant, Steven Brearey, claims it ever existed.

There are other emails from February 2016, where he tells management who have asked for an update that he has a draft report and that he will send it through the normal committees once everyone signs off on it. He sends them the earlier draft of his report which does not comment on Letby - that was added to the final version. When you read the correspondence - published in Thirlwall this year - it seems likely he has got things mixed up.

The senior management concerned said that he never received that email, and the evidence from the server bears that out. Brearey can't produce it. But what management pointed out is that they had an open door policy.

If you were concerned about deliberate harm, why would you send an email and wait a couple of months for a respose? And then you can't produce the email?

It's not plausible. Unfortunately there was a rush by the BBC and others to get exclusive interviews after the conviction, and muddles like this became part of the established narrative. It's an interesting example of how little proof you need to sell a compelling story, and how hard it is to challenge it once it is out there, even when the evidence doesn't line up.

Why were the consultants expected to lead a review of nursing care? They are completely separate professions.

In March 2016 Eirian Powell definitely emailed Alison Kelly the thematic review of increased mortality rates and that Letby had been identified as a commonality. However she says she didn’t open all the attachments…

Consultant in charge on the pediatric unit had responsibility for reviewing and reporting deaths. He worked with the nursing manager for the ward. Seems reasonable to me but obviously their decision.

As I've been saying throughout this conversation, managers (including those consultants) certainly considered the commonality around February onwards - but they investigated it with nursing review and monitoring. There were no claims that Letby was doing anything deliberate to harm children until late June 2016, a week or so before her last shift on the ward.

Kelly was cc-ed on the draft report which didn't yet identify Letby as a commonality, the one I've mentioned above. That's the email she didn't open. There was some later correspondence with Powell and others about the commonality, yes. But nothing at all from consultants about deliberate harm or wanting Letby off the ward.

Obviously nobody would just send an email if they suspected murder and then just hang around for months. What the evidence suggests is that the doctors just lost track of the sequence of events over time - perfectly normal.

Right, so perfectly reasonable that execs just passively sat there receiving evidence about commonality (there was an appendix with the thematic review email to Kelly in Feb that identified Letby as a commonality - see Thirlwall) and concerns about potential harm (eg Brearley to Powell in March 16 - ‘we still need to talk about Letby’, not to mention the disputed conversations from October 15 onwards)? There was certainly enough there for them to trigger a safeguarding concern, as Kelly has admitted. An internal nursing review and monitoring was not appropriate.

It is literally the execs’ job to take responsibility for whatever is going on within their trust, and to be particularly responsive and proactive about any serious issues - not to wait for staff to ask repeatedly via various routes that they take action.

The rape victim in the Malkinson miscarriage of justice believed that she had the truth when he was wrongfully convicted and imprisoned.

She didn't. He wasn't the man who raped her, he was innocent.

The experts need to keep quiet?! The well respected expert on the panel stated that his research was used by the dr used by the prosecution to come up with theories on how the babies died. He stated that his research had been misinterpreted and used incorrectly. Something like that is hardly irrelevant!

Even the consultant who testified he caught her red handed standing over a babies cot as their sats dropped and she did nothing. There’s an email he sent months before where he states he was there as Lucy had called him for help due to the babies poor condition. So he clearly lied under oath!

The entire trial seems like a farce. And a set up. The document showing she was there on shift every time a baby died or collapsed was misleading as they left out of that document the times a baby died or collapsed and Lucy wasn’t on shift. But the jury weren’t given than information.

I actually think it’s really scary that this can happen in this day and age. She was convicted entirely on circumstantial evidence and theories and guesswork. There was no irrefutable proof. It absolutely stinks of a cover up by the nhs.

Her character was attacked that she was emotionless in the dock, I feel I would be in that situation if I was innocent it must feel absolutely surreal and beyond belief.

I really hope it comes out one day soon and she is able to get her life back