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Serial killer Lucy Letby was nicknamed “nurse death” by junior doctors after she was removed from duty after the deaths of two triplet boys and the suspected collapse of a boy at the Countess of Chester Hospital, a public inquiry has heard.
The 34-year-old nurse was transferred to do clerical work as consultant paediatricians urged bosses to take action on the grounds of “patient safety” after the incidents over three successive days in June 2016.
A review was soon prompted by the Royal College of Paediatrics and Child Health (RCPCH) in September 2016, with leadership, doctors and nurses revealing concerns over Letby.
Yet neither the hospital or the RCPCH chose to contact Cheshire Police on the matter - leaving it another eight months before the force was formally called in and an investigation launched.
On a day of chronological evidence provided to the inquiry, Nicholas de la Poer KC, counsel to the inquiry, said some members of the review team from RCPCH were even unaware of concerns about Letby ahead of their visit.
But in an interview with former medical director Ian Harvey, notes recorded showed him raising Letby’s name as “an elephant in the room” for paediatricians concerned over the correlation of deaths with the nurse.
He added: “Want to think the worst - but nothing else is pointing to it..... Huge nettle to grasp.”
Mr Harvey also said: “Had to intervene with the neo-natal lead as junior doctors had been referring to her as ‘nurse death’. Ripples through the team and trying to function. “Can’t see how to conclude without calling the police.”
Asked “what is the tipping point” or “what is the tipping point? Not police”, he was recorded as responding “need to pull together before we press the nuclear button”.
The matter, however, was not reported to the police until May 2017.
The RCPCH team also interviewed Letby, who described herself as being “scapegoated” and “very vulnerable”, the inquiry heard.
After being questioned, the killer sent a Facebook message in which she said the interviewers had told her “off the record” they thought an investigation into the deaths would be recommended, and that “she needed to prepare herself as she would play a big part,” said Mr de la Poer.
The review ended with two reports being published; a confidential version and another publicly published.
The inquiry heard how the confidential report named Letby and described how consultant paediatricians had identifying her as “rostered on shift for all deaths and had become convinced by the link”.
However, the published version did not mention the killer and stated there “were no obvious factors which linked the deaths”, but highlighted issues with staffing levels on the neo-natal ward.
In response to the drafted report, Mr Harvey told the North Regional Medical Director of NHS Improvement, Vincent Connolly, that the RCPCH was a “very through report” and there were no immediate concerns, according to notes taken by Mr Connolly.
Yet a month after it was published, in February 2017, NHS England became aware for the first time of concerns over the link between the number of deaths and Letby, Mr de la Poer told the hearing.
Dr Michael Gregory, from NHS England, told colleagues in an email that he thought the trust was “avoiding the issue that we wish to see (contacting the police)”.
In May 2017, following a meeting involving police, the matter was reported and an investigation launched - Letby was arrested in July 2018, and then charged in November 2020 in relation to the deaths.
She is now serving 15 whole-life orders after being convicted of murdering seven newborn babies and attempting to murder seven others between 2015 and 2016.
The inquiry continues on Thursday.
