A group including some of the UK’s leading experts on neonatal care and statistics professors are calling on the government to postpone or change the terms of a public inquiry over concerns over the conviction of neonatal nurse Lucy Letby.
In a private letter to ministers seen by the Guardian, the 24 experts said they were concerned that the limited scope of the inquiry could prevent lessons being learned from “possible negligence deaths believed to be murders” at the neonatal unit of the Countess of Chester Hospital (CoC).
The public inquiryled by Lady Justice Thirlwall, was established in September last year after Letby was found guilty of the murder of seven babies and attempted murder of six others at the hospital.
The inquest was adjourned until after Letby’s retrial on a charge the original jury had been unable to reach a verdict on. That trial, which concluded in July, resulted in her being found guilty of the attempted murder of another baby.
Four judges have denied Letby permission to appeal the initial rulings. A request to appeal the later ruling is reportedly still pending.
Despite the convictions and the appeal court ruling, a small but growing number of experts are raising concerns about the evidence presented at the trial. Several experts came forward in an article published by the Guardian in July, expressing concern that Letby’s conviction was unsafe.
Only seven of the 24 signatories to the letter, sent last month to Health Minister Wes Streeting and Justice Minister Shabana Mahmood, are experts who have previously publicly expressed their concerns.
The other signatories are formally raising their concerns for the first time. They include Dr Tariq Ali, former head of the paediatric intensive care unit at Oxford University Hospitals, and Philip Dawid, emeritus professor of statistics at the University of Cambridge.
Others who have questions about the Letby case include Jane Hutton, professor of statistics at the University of Warwick, Professor Gillian Tully, a leading expert in forensic science, and Dr Neil Aiton, a neonatologist and medical expert with more than two decades of experience.
They described themselves as “a diverse group of physicians, nurses and scientists” who independently investigated the Letby case, and stressed that they were “not associated with Ms. Letby or her defense, nor are we driven by emotional responses to the case. Our approach is rooted in scientific analysis and concern for systemic issues within the health care and legal systems.”
“While we recognise the seriousness of the convictions against Ms Letby, our focus is on the wider implications for patient safety, healthcare management and the potential for miscarriages of justice in complex medical cases. We believe that legal systems are particularly vulnerable to error when dealing with complex scientific evidence, particularly in cases involving statistical anomalies in healthcare and the complex physiology of newborns.”
They disagreed with a part of the Thirlwall inquiry that directly concerns Letby, saying the natural assumption after the convictions – that she was a murderer – could lead to “a failure to understand and investigate alternative, potentially complex causes for the deaths, leading to important lessons being missed. Possible negligence deaths that were assumed to be murders could result in an incomplete investigation of the management response to the crisis”.
The main hearings of the Thirlwall inquiry begin in Liverpool on September 10. The remit is to investigate whether CoC management should have done more earlier to prevent Letby from killing babies in the neonatal unit.
The letter makes two proposals. The first is a temporary pause in the public inquiry “to allow for further investigation and to hear wider professional concerns”. The second is to amend the remit to “allow for a broader investigation into possible factors contributing to increased neonatal deaths, without the presumption of criminal intent”.
The lead signatories of the letter are Dr Svilena Dimitrova, a specialist neonatal advisor to the Care Quality Commission and a member of the independent Ockenden review into maternal and infant mortality in Nottingham university hospitals, and Peter Elston, a fellow of the Royal Statistical Society, who questioned the analysis of service data relied on by the Crown Prosecution Service before the trial began in October 2022.
The letter continues: “We emphasise that our aim is not to re-open the Letby case, but to ensure that the Thirlwall Inquiry is best placed to conduct the most thorough and useful research for the future of neonatal care in the UK.”
Other signatories include Prof Peter Green, former President of the Royal Statistical Society; Dr Neela Shabde, a paediatrician and former clinical director of the Department of Child Health in the North East of England; Jenny Harris, an experienced nurse in neonatal intensive care; and Prof Stephen Senn, former head of health statistics at the University of Glasgow.
The letter states that an additional seven neonatal and pediatric specialists, two advanced neonatal nurses and two neonatal nurses shared their concerns but wished to remain anonymous for fear of repercussions.
The intervention comes after fresh questions have been raised about the accuracy of the evidence presented at Letby’s trial. The Crown Prosecution Service confirmed last week that the CoC hospital swipe data, which the prosecution relied on to show Letby was alone when the babies collapsed, was incorrect. Police had mistakenly believed the swipe data showed nurses leaving the neonatal unit and going to the delivery room, when in fact they were returning to the neonatal unit.
In Letby’s review of the attempted murder of Baby K, the prosecution corrected the error, undermining their original claim that Letby had been alone for one incident, when in fact another nurse on duty had returned to the same room as Letby. The CPS has refused to comment on the
swipe data on the first trial.
A government spokesman said the inquiry would provide opportunities to learn from events at CoC: “This was a terrible case and there were clear failings in the NHS and regulators. The inquiry will consider all aspects of the case and the terms of reference were agreed following wide-ranging engagement with the chair, affected families and other stakeholders, including NHS England.”
A spokesperson for the inquiry said the hearings would begin as scheduled on September 10 and “would follow the terms set by the Secretary of State”.