Hospital trust where Lucy Letby worked feared ‘reputational harm’, inquiry hears

A hospital trust first characterised concerns over a high mortality rate on a neonatal unit where Lucy Letby worked as a risk to “reputational harm” rather than a threat to the safety of the infants, an inquiry has heard.

Letby, 34, was sentenced to 15 whole-life orders after she was convicted across two trials of murdering seven babies and attempting to murder seven others.

The inquiry led by Lady Justice Thirlwall at Liverpool town hall will examine events at the Countess of Chester hospital’s neonatal unit, where Letby was a nurse between 2015 and 2016. Letby was first arrested in 2018 and convicted in 2023.

On Wednesday, the inquiry heard opening statements on behalf of the counsel to the inquiry delivered by Nicholas de la Poer KC.

Turning to issues of governance at the hospital, De la Poer said the inquiry had identified that concerns about the mortality rate in neonatal unit were referred to in the July 2016 “urgent care risk register”.

“However, the risk was characterised as ‘potential damage to reputation of the neonatal service and wider trust due to apparent increased mortality within the neonatal unit’,” De la Poer said. “The risk was characterised in terms of reputational harm, rather than in terms of a risk to the safety of babies.”

De la Poer said it was noteworthy that the risk was “only added in July 2016”, six months after a review had identified a higher-than-expected mortality rate in the neonatal unit in 2015.

De la Poer explained that the increase in neonatal mortality at the hospital and the concerns about Letby were matters that fell squarely within the remit of the quality, safety and patient experience committee (QSPEC).

“A seemingly striking feature of QSPEC’s monthly meetings during the period [between] June 2015 and June 2016 is that the increase in the mortality rate on the neonatal unit was discussed just once,” he said.

Earlier, the inquiry heard that in May 2016 a “risk midwife” named Annemarie Lawrence requested a copy of the review of neonatal mortality review and – going through the table using a highlighter – identified that Letby was a common factor in the case of most of the deaths.

Lawrence took her findings to her boss, Ruth Millward, the head of risk and safety, but found Millward to be “dismissive of her findings”, De la Poer said.

Discussing the hospital board, the KC said that “in the period June 2015 to March 2017, no board committee ever escalated to the board issues relating to neonatal mortality or Letby”.

On the opening day of the inquiry on Tuesday, Thirlwall said comments on the validity of Letby’s convictions had created a “noise that caused an enormous amount of stress” for the parents of the victims and had come from people who were not at the trial.

It heard that Letby launched a grievance procedure in September 2017 over her removal from duties amid concerns about high infant mortality, which was resolved in her favour several months later.

The counsel to the inquiry, Rachel Langdale KC, said a planned return to the neonatal unit was then only stopped by the “tenacious lobbying of the consultants”. “But for their determined approach, it appears likely that she would have been permitted to return to dealing with babies,” Langdale said.

The inquiry continues.