Lucy Letby

Lucy Letby (born 4 January 1990) is a British former neonatal nurse who was convicted of murdering seven infants and attempting to murder seven others at the Countess of Chester Hospital between June 2015 and June 2016. She came under investigation after an unusual cluster of deaths and collapses in the hospital's neonatal unit, three years after she began working there.

Charged in November 2020 with seven counts of murder and fifteen counts of attempted murder relating to seventeen babies, Letby was prosecuted on the basis of her presence during many of the incidents, two abnormal blood test results and skin discolouration interpreted as signs of insulin poisoning and air embolism, alleged inconsistencies in medical records, her removal of nursing handover sheets from the hospital, and handwritten notes that the prosecution characterised as a confession. In August 2023, she was found guilty on seven counts each of murder and attempted murder, acquitted on two counts of attempted murder, and the jury was unable to reach verdicts on six further counts. She received a whole life order. One of the unresolved attempted murder charges was retried in July 2024, resulting in a further conviction.

Senior management at the Countess of Chester Hospital were criticised for failing to act on clinicians' concerns, prompting the British government to commission an independent statutory inquiry, which began hearings in September 2024. Cheshire Police examined additional cases, but the Crown Prosecution Service declined to bring further charges.

Following the lifting of reporting restrictions, several medical and statistical experts have challenged the prosecution's interpretation of the clinical and numerical evidence, arguing that the infants' deteriorations were consistent with natural causes. Two applications for permission to appeal have been refused by the Court of Appeal, and the Criminal Cases Review Commission is considering an application to refer the case back to the court.

Early life and education

Lucy Letby was born on 4 January 1990 in Hereford, the only child of a furniture salesman and an accounts clerk. She attended St. James' Church of England primary school, Aylestone School and Hereford Sixth Form College. According to a friend interviewed by the BBC, she had long expressed an interest in neonatal nursing.

Letby studied child nursing at the University of Chester, completing clinical placements at Liverpool Women's Hospital and the Countess of Chester Hospital. During her final year she failed an assessed placement but passed a subsequent retrieval placement after requesting a different assessor. One of her assessors later told the 2024 statutory inquiry that she had considered Letby inexperienced and lacking confidence in some clinical areas. Letby graduated with a Bachelor of Science in Nursing in 2011 with a speciality in child nursing in September 2011 and completed a further placement at Liverpool Women's Hospital the following year.

Career

Letby began working as a registered nurse in the neonatal unit at the Countess of Chester Hospital on 2 January 2012. She lived in rented accommodation before purchasing a house near the hospital in 2016. In a 2013 staff profile she described her role as caring for babies requiring different levels of support, and she took part in a fundraising campaign for a new neonatal unit. Colleagues later recalled that she sometimes described non‑intensive care work as boring.

She completed a neonatal specialisation course in March 2014 and undertook further training at Liverpool Women's Hospital in early 2015, and qualified to work with infants in intensive care. Her time there came under investigation after her conviction.

In July 2013, Letby and a senior colleague set a morphine infusion rate incorrectly, leading the deputy ward manager to suspend her from administering controlled drugs and require additional training. The suspension was lifted a week later after she raised the matter with the unit manager. In April 2016, she administered antibiotics that had not been prescribed, which she described as a minor error, and she was subsequently moved from night shifts to day shifts.

In June 2016, lead neonatologist Stephen Brearey asked hospital management to remove Letby from clinical duties pending an investigation. She was transferred to the patient experience team the following month and later to the risk and patient safety office, where she remained until her arrest in 2018.

Initial investigations

Concerns about an increase in infant collapses and deaths in the neonatal unit at the Countess of Chester Hospital first arose in June 2015, when four collapses occurred, three of them fatal. The unit normally recorded two or three deaths a year. The unit manager, Eirian Powell, and lead neonatologist Brearey carried out an informal review and reported the incidents to the trust's serious‑incident committee, which classified the deaths as medication errors. Brearey noted that Letby had been on duty for each incident but regarded this as an unsurprising coincidence, given staffing levels. He later told the statutory inquiry that no concerns had been raised about her practice at the time. Subsequent reporting in 2023 indicated that he had developed suspicions earlier and believed the trust failed to act on them.

A Care Quality Commission inspection in February 2016 heard concerns about difficulties raising issues with managers but was not informed of an elevated mortality rate. Its report highlighted staffing and skill‑mix problems but described a generally positive organisational culture. In May 2016, the trust's executive team concluded that the rise in deaths was coincidental. National MBRRACE‑UK data later showed that the unit's neonatal death rate between June 2015 and June 2016 was at least 10 per cent higher than expected, with deaths in 2015 double those of the previous year.

On 24 June 2016, following two further deaths, Brearey asked the duty executive to remove Letby from clinical duties, but was told she was safe to work. The trust's executive directors discussed involving the police but instead commissioned a review by the Royal College of Paediatrics and Child Health (RCPCH). Letby was taken off the unit on 30 June, and the hospital subsequently reduced cot capacity and raised the gestational‑age threshold for admissions.

The RCPCH review began in September 2016. Its October report found no definitive explanation for the increased mortality rate but identified inadequate staffing and senior cover. It described concerns about Letby as subjective and unsupported by evidence. The trust's medical director asked consultant neonatologist Jane Hawdon to undertake detailed case reviews recommended by the RCPCH. Hawdon instead conducted a brief review of medical notes relating to 17 deaths and collapses, concluding that most could be explained and might have been preventable with different care, while four warranted further local forensic review. Minutes of a subsequent board meeting recorded the medical director stating that the RCPCH and Hawdon reviews attributed the deaths to leadership and intervention issues; the board chair later said he had been misled about the depth of Hawdon's review.

Letby lodged a formal grievance in September 2016 regarding her removal from clinical duties. The trust upheld the grievance in January 2017, concluding that her transfer had been orchestrated by consultants without firm evidence. The chief executive apologised to Letby and her parents in December 2016 and instructed consultants to apologise to her in writing.

In March 2017, four consultants, including Brearey and Ravi Jayaram, again asked management to involve the police after receiving advice from the regional neonatal lead. They met Cheshire Constabulary on 27 April, shortly before Letby was due to return to clinical work. The trust publicly announced police involvement in May 2017, stating that it sought assurances to rule out unnatural causes of death. The resulting investigation, Operation Hummingbird, lasted a year. Senior Investigating Officer Paul Hughes later said the inquiry initially considered a range of natural and clinical explanations alongside the possibility of inflicted harm.

After reading about the investigation, retired paediatrician and expert witness Dewi Evans contacted the National Crime Agency offering assistance. He was instructed to review clinical records for 61 cases of sudden collapse or death. Evans produced multiple reports for Cheshire Police, and his conclusions were peer‑reviewed by consultant neonatologist Sandie Bohin. He also advised on the appointment of further specialist experts. The police ultimately narrowed the investigation to 22 cases, which formed the basis of the charges at Letby's trial.

2023 trial

Police arrested Letby on 3 July 2018 on suspicion of eight counts of murder and six counts of attempted murder. Following her arrest, detectives began reviewing her entire nursing career, including her time at Liverpool Women's Hospital. She was bailed on 6 July, rearrested in June 2019, and bailed again shortly afterwards. Letby was arrested for a third time in November 2020 and was remanded in custody. She denied all allegations, attributing the collapses to issues such as staffing levels and hygiene.

Letby's trial opened 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. Her parents and the families of the infants attended the proceedings.