Lucy Letby latest: Inquiry judge says speculation over conviction has caused ‘enormous stress’ for parents

The inquiry has paused and will restart in an hour. We will continue with updates when evidence resumes.

An email by Dr Steve Breary following May 2016 to chief nurse Alison Kelly highlighted Letby’s connection to babies’ deaths.

Ms Kelly then reportedly emailed medical director Ian Harvey asking for a meeting noting “Hi Ian please see Steve’s comments below which alarm me.”

“I’m currently reassured there were no issues but I think this is worth a wider review”

She allegedly was assured by ward nurse Eirain Powell that the creation of a table linking Letby to the deaths was more to do with concern over her well-being.

Notes by Ms Kelly of a meeting where concerns about Letby were discussed between herself, Mr Harvey, Ms Powell and another manager Ms Murphy state, “absolutely no issues with nurse and circumstantial.”

According to evidence by Ms Kelly, she described ward manager Ms Power as being “vociferous” in Letby’s defence and Dr Breary described her as “defensive” over the nurse.

However, Mr Harvey said the tone of the meeting was calm adding “I don’t remember anyone being forthright about concerns about Letby.”

In 2016 one of the doctors, Dr Ravi Jayaram, who had been raising concerns, sent an email to other senior managers saying “I think we need to still talk about Lucy.”

According to KC Langdale, no meeting took place but Dr Jayaram claimed several “corridor conversations” were had about his concerns in relation to Letby.

A later meeting was requested with the trust chief nurse Alison Kelly. In evidence to the inquiry, Ms Kelly said at the time there was nothing in an email from ward manager Ms Powell to suggest there were grave concerns about Letby, the tone and content of the email did not suggest there was a need for an immediate meeting.

Referencing a thematic review which had been carried out in February 2016, the inquiry said by by March 2016 both Alison Kelly and medical director Dr Ian Harvey had received the report directly. Dr Harvey had received it twice by this point.

Ms Kelly reportedly called for a meeting to take regarding the report after recieving it but this did not happen until 11 May 2016.

Between 17 March and 11 May 2016, Letby was moved from night shifts to day shifts where she attacked two further children, the inquiry heard.

Following the death of Child I, Dr Stephen Breary emailed senior managers and directors following a more detailed review of the baby’s death.

Rachel Langdale KC said there was no linking factor in the first, three deaths, however, it appears to be the death of Child I that first led Dr Breary to raise his concerns about Letby.

He allegedly noted the repeated nature of Child I’s collapses and improvement when they were moved away from the Countess of Chester to Arrow Park Hospital in Liverpool

However, in an email response Eirian Powell, who was the neonatal unit ward manager, said “It is unfortunate Letby was on [shift].”

Ms Powell attached to the email a table which identified all of the babies that died and all of the nursing staff on duty.

KC Langdale said, “This document was compiled by Ms Powell who held Letby in high regard.”

“We will be considering what it [the table] does and does not signify.

In a later email, she informed Dr Breary that said “We did not think there was a connection” between Letby and the babies’ deaths.

However, months later a further analysis would identify her as present at each incident.

Following the death of child E, blood results indicating the presence of insulin in babies were not escalated or communicated, according to the inquiry evidence.

Countess of Chester medical director, Ian Harvey, has told the inquiry in his evidence that had the presence of insulin in the babies’ blood results been flagged to him, this would have changed his perception of what was occurring at the Countess of Chester neonatal unit.

The inquiry will return to examine the role of the executive board at the Countess of Chester Hospital.

Following the first three deaths, doctors and nurses noted Letby was present but considered she was “merely unfortunate.”

One nurse shared concerns with Letby over the loss of three babies in 12 days.

She said in a message: “There’s something odd about that night and the fact that we lost three that went so suddenly…” she messaged Letby. She did not share her thoughts with anyone but Letby, there were no formal meetings, conversations or debriefs, according to the inquiry.”

The inquiry has resumed…

It is said those at the meeting failed to document which staff were present at each death so far and commonalities such as rashes, which were also seen on Child B. However Child B’s collapse was not included at the meeting.

KG Langdale said had these factors been considered in July 2015 as a minimum Letby’s presence at each death and the unexpected collapse of Child B would’ve been considered, including the rashes, and could’ve been considered in greater detail.

She said: “It would take two more babies [to be harmed] that staffing would be revisited.”

The meeting also did not include any of the doctors or nurses who were actively present during the incidents.

This, KC Langdale said, calls into question the efficacy of serious incident panels.

In her opening, Rachel Langdale KC talked of other NHS clinicians who have been accused of harm and murder

She said: “History tells us that serial killers are deceptive, manipulative and skilled at hiding in plain sight.”

She said an inquiry into Harold Shipman, a GP thought to have murdered hundreds of his patients, shed little light on why he carried out his crimes and found he was able to kill undetected over many years, enjoying a high reputation.

She added: “For ordinary, decent right-thinking people the actions of Letby will remain unfathomable. We will not be inviting speculation from witnesses about her motive or mindset.”

She said the inquiry would examine why detailed medical analysis of the deaths and collapses of babies did not take place earlier and whether bias in favour of Letby influenced the hospital’s response.

She said: “It was not until April 2017, almost two years after the first murder, that the hospital made a referral to the police and detailed multi-disciplinary medical scrutiny and analysis was finally conducted.”

The inquiry has paused for a break and will resume shortly. We will be bringing you all the latest updates once it resumes.

It is due to finish at 16:30.

According to evidence from KC Rachel Langdale, following the deaths of three babies in 12 days an executive meeting was called.

During a review meeting with top executives, on 2nd July 2015, including the chief nurse Alison Kelly, doctors and ward managers noted Letby’s presence during all of the incidents.

However, nothing untoward was suspected by those in the meeting.

Dr Stephen Breary remembered saying “Not Lucy, not nice Lucy.”

KC Langdale said, “We will consider what biases played a part in what inquiries and conclusions took place next.”