Prosecutions, trials, and convictions
Arrest and charges
On 3 July 2018, Letby was arrested by police on suspicion of
eight counts of murder and six counts of attempted murder, following a
year-long investigation. Letby's home at Chester was searched by police
following her arrest. After Letby's
arrest, the investigation was widened to include Liverpool Women's Hospital,
another location at which Letby had worked. Police have begun looking into
Letby's entire career, including at Liverpool Women's Hospital, since her
conviction.
Letby was bailed on 6 July 2018 as the police continued
their inquiries. Time had to be taken to review the unexpectedly large amount
of document evidence found in Letby's home. In her diaries were found what
appeared to be a code of colored asterisks that marked significant events in
the investigation. She was rearrested on 10 June 2019 in connection with eight
said murders and nine said attempted murders of babies, and again on 10
November 2020. She was bailed in 2019 as more time was needed to get evidence
together to make sure it was as strong as possible before charges could be
brought. There were thousands of exhibits in the investigation, 16,571 of which
were not even used as evidence and some of the items were themselves thousands
of pages long. The 2019 arrest and bailing had been made as by this time three
further cases of attempted murder had been identified which investigators
needed to question Letby further on and as Letby had been found to have written
extensively about the case on her 2018 arrest, detectives wished to see whether
she had written anything further in the year while she was under investigation.
The key aspects of the investigation, which has been described as 'painstaking', were, according to Senior
Investigating Officer Paul Hughes, "always
asking ourselves a) who else could it be, if not her, and what else could it
be?”
On 13 March 2020, Letby was placed on an interim suspension
by the Nursing and Midwifery Council.
On 11 November 2020, Letby was charged with eight counts of
murder and 10 counts of attempted murder. She was denied bail and remanded in
police custody. The Crown Prosecution
Service was convinced to approve all of the charges Cheshire Constabulary requested against Letby after it reviewed the
evidence the force collected against her.
Letby denied all 22 charges against her, blaming the deaths
on hospital hygiene and staffing levels.
On 18 August 2023, Andrea
Sutcliffe, Chief Executive and Registrar of the Nursing and Midwifery Council, stated that Letby "remains suspended from our register,
and we will now move forward with our regulatory action, seeking to strike her
off the register".
2023 Trial
Letby's trial began at Manchester
Crown Court on 10 October 2022 before Mr.
Justice Goss. She pleaded not guilty to seven counts of murder and 15
counts of attempted murder. Letby's parents and the families of the victims
attended the trial.
The child victims were referred to as Child A to Child Q.
The press secrecy around the identities of the 17 babies and nine colleagues
who gave evidence was "rarely seen
outside proceedings involving matters of national security." Two years
before the criminal trial, Mrs. Justice
Steyn banned the identification of the living victims until their 18th
birthdays. Parents wanted their identifying information to be protected, though
Steyn J ruled that one parent's profession as a physician was relevant because
of his medical expertise and that it would not make that parent identifiable to
the public. Several witnesses requested anonymity, including a doctor with whom
Letby was reportedly infatuated. The judge approved these requests, ruling that
getting testimony from the colleagues was more important than them being
publicly identifiable.
The prosecutor said that Letby was a "constant malevolent presence" in the hospital's neonatal
unit. Some witnesses had apparently walked in during, or just after,
Letby's attacks. A mother of one of the victims said she had walked in on Letby
trying to kill her baby, with Letby saying "Trust
me, I'm a nurse" when interrupted. Another mother had walked in
hearing her baby screaming, to find her child had blood around his mouth with
Letby in the room. The mother said that, despite the obvious distress the baby
was in, Letby was just "faffing
about, not really... not doing anything. You know when it feels like somebody
wants to look busy but they're not actually doing anything?” Letby told
the mother to go back to the ward. The baby's condition soon worsened and it
later died in its parents' arms. No post-mortem was carried out, which might
have shown what Letby had done. Afterward, Letby bathed the deceased baby in
front of her parents. Another mother of a baby, who had died in October 2015,
recounted an uncomfortable experience of Letby bathing her child, recounting: "Lucy Letby and another nurse asked me
if I wanted to bathe my baby. While we were bathing her, Lucy came back in. She
was smiling and kept going on about how she was present at the first bath and
how our daughter loved it. I wished that she would just stop talking".
Letby's apparent obsession with this baby and her family later continued;
she sent a sympathy card to the parents after the baby's death on the day of
its funeral. Upon Letby's arrest, it was found on her phone that she had
photographed the card before she sent it and had still kept pictures of it.
I think there is an
element of fate involved. There is a reason for everything.—Text sent by Letby to a colleague after one of the murders
Police had discovered during their investigations that Letby
had sent texts to others after each of the deaths. She asked one: "How do such sick babies get through
& others just die so suddenly & unexpectedly?” In another, sent on
9 April 2016 during a day shift after two twin boys, Child L, and M had
collapsed, she wrote: "Work has been
shit but... I have just won £135 on Grand National!!! Unpacking party sounds
good to me with my flavored vodka". On 22 June 2016, on the evening
before her return to work following a holiday in Ibiza, she texted: "Probably be back in with a bang".
Notably, on her first shift back that next day, Child O was murdered. The texts
were seen as important as they sometimes appeared to be a live blogging of
events. Letby had also told a colleague that taking Child A to the mortuary was
"the hardest thing she ever had to
do". Letby had also searched for the parents of several infant victims
on Facebook, in one case on the anniversary of a baby's death. In total Letby
had searched for 11 of the families affected. When police had asked her why she
had searched up the parents of Child O on the anniversary of its death, she had
responded that she "could not
explain why she would be doing it". The prosecutor asserted that Letby had
injected air into the bloodstream of two victims and had used insulin to murder
others. It was also revealed during the trial that Letby had to be told more
than once not to enter a room where the parents of one of the victims were
grieving. Letby said, "It's always
me when it happens."
Letby's defense lawyer said that Letby was "a dedicated nurse in a system which
has failed," and that the prosecution's case was "driven by the assumption that someone was doing deliberate harm
combined with the coincidence on certain occasions of Miss Letby's
presence," and that there had been a "massive failure of care in a busy hospital neonatal unit – far
too great to blame on one person." The defense argued that "extraordinary bleeding" in a
baby boy murdered by Letby could have been caused by a rigid wire or tube. The
therapeutic use of insulin was denied by Letby's colleagues. No baby on the
unit was being prescribed insulin so there was no reason why any baby
should have been given it. The insulin was kept in a locked fridge next to a
nurses' station.
A key piece of evidence was also given by a consultant who
recounted that in February 2016 he had walked in and seen Letby standing over a
baby and watching when they seemed to have stopped breathing. Letby was not
doing anything despite the baby desaturating. When he asked her what was going
on, she responded that he had only then just started declining. This baby went
on to survive their collapse. By this stage, all seven of the pediatrician
consultants who worked in the neonatal ward agreed something was seriously wrong
in the department. The deaths and near-deaths that were happening on the unit
could not be medically explained. All the babies involved had been expected to
live and so their deaths came out of the blue. Previously, in the majority of
times the premature babies had collapsed it had already been expected and in
the very rare cases, it was not already expected it could still be medically
explained, unlike in all of these cases. A pediatrician testified that he and
other clinicians had previously raised concerns about Letby, but were told by
hospital administration that they "should
not really be saying such things" and "not to make a fuss." Another doctor testified that Letby
commented an hour before one victim died, "He's
not leaving here alive, is he?"
Between March and June 2016, another three babies almost died
while under Letby's care. Towards the end of June, she was helping to care for
triplets. One died at 6 pm one evening and peculiarly another of the triplets
died less than 24 hours later, both under Letby's watch. Both of them had been
in very good health and the deaths on consecutive days were causing staff
considerable distress and shock, with the notable exception of Letby, who
merely told one consultant that she would be back on shift the next day when
she was asked if she was upset after the events of the two days. This was not
the first time that twins/triplets had collapsed within 24 hours of each other
while under Letby's care, as two twins had experienced collapses on consecutive
days in August 2015. Only hours after one of the twins had died that month,
the other became seriously unwell and it was only during the police
investigation and after analysis of a blood sample that it was found that
someone had intentionally poisoned the baby with insulin. This evidence had
been missing for two years. The insulin, which had not been prescribed to the
child, was identifiable as exogenous pharmaceutical insulin as C-peptide would
be present in the specimen if the insulin had been produced by the baby
Laboratory analysis also showed that 'Baby
L' had been poisoned with insulin. This was also significant as only hours
later his twin brother, 'Baby M',
inexplicably collapsed while under Letby's care but managed to survive after
thirty minutes of resuscitation. It was believed that Letby had injected air
into the latter's bloodstream. The prosecution also noted that, although by
this point she was not supposed to work night shifts, Letby was caring for
Child L as she specifically volunteered to do an extra shift to care for it,
the prosecution arguing that she had seen an opportunity here to kill Child L
where she had failed previously with Child F. Letby herself accepted at trial
that the results showed that some victims had been deliberately injected with
insulin and did not contest that someone must have administered it to them. The
night after Letby tried to murder Child F she went salsa dancing.
Although the consultants made their desire to have Letby
removed from duties known to hospital staff after the triplet incident, this
was refused and the next day another baby almost died under Letby's care. As
well as in the two cases in which insulin poisoning had been proved, evidence
provided by medical experts indicated that all the babies had been harmed
intentionally. This evidence was given by experts specializing in areas of pediatric
radiology, pediatric pathology, hematology, pediatric neurology, and pediatric
endocrinology, with two main medical experts who were consultant pediatricians.
Letby was the only staff member on duty for every one of the 25 suspicious
incidents. As soon as she was removed from duty, the suspicious incidents
stopped. Importantly, it was discovered that Letby had falsified patient
records, covering her tracks by changing the times some babies collapsed to
make sure she could not be placed at the scene. Criminal psychologist Dr. David Holmes states that the varied
methods she used to attack her victims, such as insulin and air injections and
overfeeding milk, would all have been specifically chosen as things that would
dissipate and not be easily detected afterward.
On the fourth day of trial, the prosecution presented a
handwritten note from Letby which said "I
am evil, I did this," and that she "killed
them on purpose" because she "couldn't
take care of them." It further stated "I killed them" and "I'll
never marry or have children, I'll never know what it's like to have a
family". The defense argued that the note was "the anguished outpouring of a young woman in fear and despair
when she realizes the enormity of what's being said about her, at the moment to
herself" and said that Letby had written it when she was dealing with
employment issues, including a grievance procedure with the NHS Trust. Several
other notes from Letby were shown in court, two of which said, "Why/how has this happened – what
process has led to this current situation? What allegations have been made and
by who? Do they have written evidence to support their comments?" And,
"I haven't done anything wrong and
they have no evidence so why have I had to hide away?", both of which
were Letby expressing frustration about not being allowed back to work in the
neonatal unit. The police had also discovered that Letby had secretly kept
medical documents at home relating to the care of the children. confidential
hand-over sheets, resuscitation sheets, and blood gas readings were taken from
the hospital and it was later concluded that she'd kept these as some sort of
trophy, with her trial judge stating that she had kept these as 'morbid records' of her murders. The
sensitive documents, which should never have left the hospital, contained the
names of the babies and the documents had been stuffed and hidden away in
shopping bags under her bed. One note of medications given to a baby boy who
had managed to survive after being on the brink of death, written on a paper
towel, was found under Letby's bed. Letby claimed at trial that she had no
means of destroying the confidential notes, yet the court heard a paper
shredder that could have done so was found in her home. Her diary was also
found to be marked with the initials of the babies she killed on the exact days
they died. It was within this diary that the note that stated "I am evil I did this" was
tucked inside. Furthermore, more notes were discovered that contained phrases
such as "I'm sorry that you couldn't
have a chance at life", "I don't want to do this anymore",
"how can life be this way?", "hate my life" and "help" in capital letters. The
prosecution said the notes were evidently confessions of guilt, rather than
just the words of a woman in "distress".
These notes and documents had been found in searches of Letby's home in Chester
and of her parents' house in Hereford.
Letby herself gave evidence to the court in May 2023,
breaking down in tears and claiming she was made to feel as though she were
incompetent but "meant no
harm." When asked why she wrote "I am evil, I did this," Letby said, "I felt at the time that if I'd done something wrong I must be
such an evil, awful person. I'd somehow been incompetent and had done something
wrong which had affected those babies." Letby said that the
allegations had negatively impacted her mental health, saying, "I don't think you can be accused of
anything worse than that. I just changed as a person, my mental health
deteriorated, and I felt isolated from my friends on the unit. From a
self-confidence point of view, it made me question everything about
myself." It was observed that Letby eventually began to lose her
composure in the witness box, asking for several unplanned breaks. It was
also observed that she only broke down when talking about herself and the
impact it had on her, which the prosecution said was "telling". She had not shown any emotion about
the fate of the babies. It was also noted that she repeatedly contradicted
herself, muddled up her story, and became more and more frustrated with the
prosecution's questions, which was unlike her usual calm demeanor.
Verdicts and
sentencing
On 10 July 2023, after a nine-month trial, the jury was sent
to deliberate. Verdicts were returned by the jury on several days starting on 8
August, but it was not until the final verdicts were returned on 18 August that
the verdicts were made public.
Letby was found guilty of seven counts of murder of seven
babies. She killed them by injecting them with air, overfeeding them, poisoning
them with insulin, and assaulting them with medical tools. She is the most
prolific serial killer of children in modern British history.
Letby was also found guilty of seven counts of attempted
murder of six infants. Letby was found not guilty on two counts of attempted
murder. The jury was unable to reach verdicts on six further attempted murder
charges. Nicholas Johnson KC asked the court for 28 days to consider whether a
retrial would be sought for these six counts.
On 21 August 2023, Letby was sentenced to life imprisonment
with a whole life order, the most severe sentence possible under English law;
she is the fourth woman in UK legal history to receive such a sentence. Goss
said that Letby committed "a cruel,
calculated, and cynical campaign of child murder involving the smallest and most
vulnerable of children." In closing, he stated, "There was a deep malevolence bordering on sadism [...] you
[Letby] have no remorse [...] there are no mitigating factors [...] the
offenses are of sufficient severity to require a whole life order."
Letby opted not to attend the sentencing hearing and as such
heard neither the various victim impact statements which were read out nor her
sentence being passed. In response, Alex
Chalk, Secretary of State for
Justice, wrote that the government will "look
at options to change the law at the earliest opportunity" to compel
defendants to attend their sentencing. Letby's parents, who had been present
throughout her trial, also did not attend her sentence hearing. On 30 August
2023, Prime Minister Rishi Sunak announced
that the UK government would introduce legislation to Parliament that would
compel convicted criminals to attend their sentencing hearings, by force if
necessary, or face the prospect of more time in prison.
After the trial, Lucy Letby was transferred to HMP Low Newton, a closed prison for
women in County Durham.
Appeal
On 15 September 2023, the Court of Appeal Criminal Division confirmed that Letby had lodged
an appeal against all her convictions.
Scheduled retrial
At a hearing on 25 September 2023, the CPS confirmed that
there would be a retrial on one of the six counts of attempted murder against
Letby on which the jury at the original trial could not reach a verdict. A date
of 10 June 2024 has been set but the trial will not be conducted until after
the Court of Appeal has considered whether or not to grant Letby's appeal against
existing convictions.
Motives
During Letby's trial, the prosecution suggested several
possible motives for the killings including boredom, that she "got a thrill" from the events
surrounding the deaths, and that she enjoyed "playing
God". The prosecution told the jury that "[s]he was controlling things. She was enjoying what was going on.
She was predicting things that she knew were going to happen." Another
possible motivation suggested by the prosecution was that the killings were to
gain the attention of a married doctor with whom Letby allegedly had a secret
relationship. She had texted this doctor 'non-stop' during some night shifts,
minutes before attacking babies. He was one of the doctors called when a baby
rapidly deteriorated. Letby denied all these suggestions, including the
allegation that she had a relationship with the married doctor. Among the notes
that were found in Letby's home in police searches were declarations of love
for the colleague. Some of the notes read "I
trusted you with everything and loved you", "You were my best
friend" and "Please help
me". During her trial, it was noted that Letby broke down for the first
time only when this doctor who she allegedly had a crush on gave evidence and
she tried to leave the dock without permission at this point. When questioned
why she did this Letby said she had "felt
unwell" and when questioned, she claimed she "didn't know" what 'go
commando' meant, even though the doctor she allegedly fancied had sent it
to her in an apparently flirtatious text, to which she replied to with laughing
emojis.
The Guardian, in
its reporting after the verdict, said that "[t]he
closest the prosecution had to a confession" were post-it notes found
in Letby's handbag after her arrest. The notes bore hand-written jottings, one
of which read, "I killed them on
purpose because I'm not good enough to care for them." During the
trial, Letby denied this was a confession and that it was merely a reflection of
her mental turmoil written while she was being investigated. The Telegraph also
noted that she had suggested another motivation was her fear of
never finding love or having children of her own, writing on the note: "I'll never marry or have children,
I'll never know what it's like to have a family."
A former detective superintendent, the lead detective on the
Beverley Allitt case of the 1990s,
said that the number of parallels between the cases made him think that "it's almost as if somebody's read the
Allitt book" and that Letby's crimes may have been copycats. Allitt
had attacked over a dozen infants in her care while working as a nurse in
Grantham, England, and the methods used in the cases were apparently identical,
with Allitt having also injected some victims with air and insulin and physically
assaulting them. It was believed that Allitt may have been motivated by what
was then called Munchausen's by proxy, in which she harmed others to gain
attention for herself and it may be that this also explains Letby's attacks.
Criminal psychologist Dominic Wilmott
subscribes to this theory, commenting: "She
wants to be involved in this case. She actually has the perfect opportunity not
to be, right? So we expect most offenders to not want to get caught and to
distance themselves from their offending behaviour. Beverley Allitt and Lucy
Letby seemed to be injecting themselves into the inquiry, into the
circumstances, so it shows that there's something else going on here."
Just like in Letby's case, the hospital in Allitt's case was criticized for its
slow speed of response. Fellow criminal psychologist Dr David Holmes agrees
that Letby was motivated by Munchausen's. Criminologist David Wilson agrees
that in Letby's case, Letby seemed to have a "hero complex". Witnesses had testified that Letby indeed
looked for action, saying she found the less non-intensive care of babies "boring" and always wanted to
be treating the most serious cases in the intensive care unit.
According to Wilson, healthcare killers like Letby "[have] already developed the desire to
kill before they join the healthcare setting". Speaking on Newsnight, he said: "If you want to kill, of course you are
going to identify vulnerable people. People whose deaths won't be
noticed. And so guess what? The people that serial killers target, by and large,
are older, or they target very very young people, specifically in a
neonatal unit in this case, where again small babies with chronic underlying
healthcare where their deaths won't be commented upon or seen as being
suspicious".
Post-conviction
Further investigations
Following the verdict, it was reported that police were
investigating whether Letby harmed other babies. There was a continuing
investigation of suspicious incidents at the Countess of Chester Hospital involving around 30 other infants.
Altogether, the records of 4,000 children are being looked into. Although the
jury was only asked to consider seven murder charges against Letby, there were
a total of 13 baby deaths on the neonatal unit in Letby's final year working
there and Letby was on duty for all of them. Since Letby stopped working at the
Countess of Chester Hospital, there
has only been one death in seven years in the unit, which has not since cared
for such sick babies. Even when it had cared for these sick babies, the ward
had usually only seen two or three deaths a year.
Letby also worked at Liverpool
Women's Hospital from 2012 through 2015 and police are investigating all
neonatal admissions at that hospital during that time, including those of two
babies who died while Letby was training there. The families of several babies
have been told that their child's birth at the hospital is within the scope of
the investigation. Cheshire Police have said that further charges could "possibly" be brought against
Letby as a result of these further investigations.
Independent inquiry
After Letby's conviction, the UK government ordered an
independent inquiry into the circumstances surrounding the murders. The
Department of Health and Social Care said the inquiry would examine "the circumstances surrounding the
deaths and incidents, including how concerns raised by clinicians were dealt
with." It was affirmed that the inquiry would be non-statutory, so
witnesses could not be compelled to give evidence and inquests would still be
necessary. The trust's medical director, chief executive, and the nursing director
at the time of the murders all commented they would fully cooperate with the
inquiry. The medical director retired in August 2018 and the chief executive
resigned in September 2018 after signing a non-disclosure agreement.
Slater and Gordon, a law firm representing two of the
victims' families, issued a statement calling for the inquiry to have the power
to compel witnesses to participate since a non-statutory hearing "must rely on the goodwill of those
involved to share their testimony." The need for a statutory inquiry
was a view echoed by, among others, Sir
Robert Buckland, former Secretary of
State for Justice, Samantha Dixon, MP for the City of Chester, Steve Brine, chair of the House of Commons Health and Social Care Select Committee, Sir Keir Starmer,
Leader of the Opposition, and the Parliamentary
and Health Service Ombudsman.
The education minister Gillian
Keegan said that the type of inquiry would be reviewed after the chair was
appointed. On 30 August 2023, Health
Secretary Steve Barclay announced that the inquiry had been upgraded to a
statutory inquiry, describing it as the best way forward and meaning that
witnesses would be compelled to give evidence Lady Justice Thirlwall will chair the inquiry.
Calls for regulation
and reform
The British Medical
Association, which represents doctors, called for a process for NHS
managers and healthcare administrators to be held accountable for
mismanagement, in a similar way to how the General
Medical Council may strike off doctors who harm patients. A neonatal
consultant who alerted administrators about his suspicions about Letby also
called for regulation of healthcare management.
The Parliamentary and
Health Service Ombudsman Rob Behrens, called for radical change to NHS
management to prevent future similar occurrences.
Doubt about
conviction
The Telegraph
reported that some people have attempted to spread doubt and conspiracy
theories about Letby's conviction, and a campaign to raise money for an appeal
was started. The Telegraph said that the theory that Letby was innocent was "extremely hard to entertain" and "sounds like the kind of mad claim that
swirls around dark corners of the internet long after a case is closed."
The New Statesman criticized the
large amount of 'true crime' content produced on the case and drew parallels
with the events surrounding the recent disappearance of Nicola Bulley, stating:
"The Letby case has demonstrated a
trend of people believing – despite having zero expertise – that their personal
opinions on a stranger’s innocence, guilt or appropriate punishment are
relevant."
On 27 August 2023, the
Independent reported that several of Letby's former hospital colleagues
and friends do not believe that she is guilty. One close friend and colleague
of Letby, who had always maintained her innocence, did reveal she had actually
become convinced by the end of the trial that Letby was guilty and felt 'duped'
by her, saying: "I have no doubt at
all that she was guilty of these despicable crimes, having seen the reports of
the evidence. I did not attend the trial so I had an incomplete picture until
the verdicts were announced, and more detail provided." She added: "I was deceived, as were so many
others."
Other reactions
Dewi Evans, a
retired consultant pediatrician who served as a prosecution witness, has called
for an investigation into the possibility of charges of corporate manslaughter
in the Letby case.
The Royal College of
Pediatrics and Child Health stated, "We
must learn from these crimes and how Lucy Letby was able to bring harm to these
babies so that no situation like this can ever happen again" and
welcomed the independent inquiry. NHS
England's Chief Nursing Officer Dame Ruth May issued a statement saying, "The NHS is fully committed to doing
everything we can to prevent anything like this ever happening again, and we
welcome the independent inquiry announced by the Department of Health and
Social Care to help ensure we learn every possible lesson from this awful
case."
On 21 August 2023, it was announced that the nursing
director at the Countess of Chester
Hospital at the time Letby was based there had been suspended from her job
as a senior nursing officer at Northern
Care Alliance NHS Foundation Trust with immediate effect, because of
information that came to light during the trial. The Nursing and Midwifery Council subsequently announced she would face
an investigation into her fitness to practice. She and other executives at the
hospital have been accused of ignoring warnings about Letby.
It was reported that the British government was examining
how Letby's pension could be stopped. The NHS pension scheme regulations provide
for a forfeit of pensions after a conviction of certain crimes.
The Government announced that it would introduce new powers
to compel convicted criminals to attend sentencing hearings.
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