Lucy Letby
Damning email told of ‘chaos’ on Lucy Letby ward
A senior doctor warned that the neonatal unit where Lucy Letby worked was chaotic, overstretched and unsafe for patients and staff two years before the serial killer nurse was suspended.
Dr Alison Timmis, a paediatrician, emailed Tony Chambers, the hospital’s chief executive, in December 2015, reporting that staff were in tears because they were being forced to look after more babies than the unit could safely accommodate.
In her note, copied in to other senior managers, she told him: “Over the past few weeks I have seen several medical and nursing colleagues in tears . . . they get upset as they know that the care they are providing falls below their high standards.” Staff at the Countess of Chester Hospital were “chronically overworked” and she felt “no one is listening”.
“This is not an exceptionally busy week,” she wrote. “This is now our normal working pattern and it is not safe. Things are stretched thinner and thinner and are at breaking point. When things snap, the casualties will either be children’s lives or the mental and physical health of our staff.”
Letby, 33, capitalised on the difficulties the neonatal unit faced to target her victims. Evidence seen by The Sunday Times shows she was keen to work nights and weekends and volunteered to do extra shifts to plug staffing gaps. This often left her alone with children she was not allocated to care for and she used the opportunity to attack and kill them. Many of the incidents were clustered between midnight and 4am.
By the time Timmis’s email was sent, Letby had murdered five babies and tried to kill another three, one of them twice. She would kill another two babies and attack three more before being moved off the unit in 2016 after doctors raised concerns about her. Last week she was sentenced to life in prison after a 10-month trial found her guilty of seven murders and seven attempted murders.
Separately, Dr Sandie Bohin, an expert witness for the prosecution in Letby’s trial, has described babies screaming in agony after being attacked by Letby. In her first in-depth interview, the neonatologist and consultant paediatrician said abnormal insulin tests results were missed after being sent through the post and filed away in thousands of pieces of paperwork, with no computer system in place.
In other developments, ministers are expected to bow to pressure to appoint a judge to lead an inquiry, with powers to compel evidence on oath, if families demand it. The Home Office has given Cheshire police an additional £2.4 million to support its investigation into Letby.
Timmis’s two-page email to Chambers, which copied in the medical director, Ian Harvey, and other managers, was sent after the paediatrician had worked a 21-hour shift over a Friday and Saturday. She said another colleague worked 23 hours over the same weekend. The neonatal unit was forced to close repeatedly and had three or four babies more than its “maximum capacity” the previous week, she said.
Harvey, and other managers, was sent after the paediatrician had worked a 21-hour shift over a Friday and Saturday. She said another colleague worked 23 hours over the same weekend. The neonatal unit was forced to close repeatedly and had three or four babies more than its “maximum capacity” the previous week, she said.
“A midwife had to come from [the] labour ward to help check emergency resuscitation drugs as there was not enough trained nursing staff on the unit. At several points we ran out of vital equipment such as incubators,” she wrote. At one stage she told Chambers that a baby had to be intubated — a tube inserted to help them breathe — in the middle of a room as there were no free bed spaces.
Highlighting a lack of staff, Timmis said: “We do not meet the national standards for paediatric nurses, neonatal nurses, or doctors.”
Neonatal units should have a specific number of nurses to care for the babies on the ward depending on how sick they are. At the time Timmis sent her email, the ward had a fifth fewer nurses than it should have done. This is common across neonatal units in England due to nurse shortages.
Richard Scorer, head of abuse law at Slater & Gordon, who is representing two families whose babies were targeted by Letby, said: “The issues raised in this email are very troubling. It suggests there were serious systemic problems in the hospital which Letby was able to take advantage of.
“This is all the more reason why we need a statutory inquiry which has the power to compel hospital managers to give evidence under oath, and the power to compel production of documents. There is a huge amount about this case which needs to be investigated. Only an inquiry with full powers can do this.”
Bohin, who reviewed cases for the prosecution of Letby, described how some of the babies “screamed” after being attacked by the nurse. “Babies will cry if they are in pain, obviously, such as when you take blood or put in a drip,” she said.
“That hurts, and there’s no getting away from it. But to have a premature baby screaming is really unusual. What was described on the ward was babies screaming for up to 30 minutes. Now that is just unheard of. Somebody had done something to cause those babies extreme pain.”
Describing the moment she realised babies had been intentionally harmed, Bohin, who lives in Guernsey, added: “I was sitting at my dining room table in the winter, and it was dark outside, and I was looking at this baby’s x-ray, thinking, ‘This baby has had an air embolism.
“Then I thought, ‘It can’t be.’ I’d never seen anything like that in my career . . . but nothing else explained it.
“The x-rays were in front of me, several of them, all showing air in the babies’ vessels. That’s when I thought: ‘No, it has to be, and it has to be deliberate.’”
The attempted murders of Baby F and Baby L, two children poisoned with insulin, were pivotal in proving sabotage at the hospital. Blood tests showing high levels of insulin in the blood were missed by doctors — it was only when the cases were reviewed for the police years later that the abnormal test results were uncovered, buried in a stack of medical notes. Bohin said one of the baby’s medical files alone contained 5,000 pages.
Letby also managed to slip through the gaps in the coronial system. Hospital managers asked the Cheshire coroner, Dr Nicholas Rheinberg, to investigate the seven baby deaths in February 2017. The coroner declined, according to sources, telling the trust he was not a “quality-assurance service” for the NHS. Rheinberg retired that year.
Last week, The Sunday Times revealed in detail how consultants tried to raise the alarm about Letby but managers failed to act.
An internal investigation into how the scandal was handled by managers was commissioned by former chief executive Susan Gilby, who joined the trust in 2018.
She believes it has been finished and should be published. “The explicit plan was for it to be published straight after the trial verdict, as I knew a government inquiry could take years. The families deserve to know the truth about what happened,” she said.
The Countess of Chester trust said the report needed legal checks and had not yet been finalised, adding it would want to discuss its publication with the new inquiry chairman first.
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