A group of leading UK neonatologists and statistics professors are calling on the government to postpone or change the terms of the hearing, raising concerns about the conviction of neonatal nurse Lucy Letby.
In a private letter to ministers, seen by the Guardian, 24 experts said they feared the restrictive terms of the inquiry could prevent lessons being learned about the “possible death by negligence, presumed to be homicide”, which occurred on the neonatal unit at the Earl of Chester Hospital (CoC).
of Public investigationThe special tribunal, headed by Judge Thirlwall, was established last September after Lettby was found guilty of killing seven babies at the hospital and attempting to kill six more.
The trial was postponed pending the completion of Letby's retrial after the original jury was unable to reach a verdict. In that trial, which ended in July, Letby was found guilty of the attempted murder of another baby.
The four-judge bench dismissed Mr Letby's appeal against the initial sentence, but an appeal against the later sentence is understood to be pending.
Despite the guilty verdict and the Court of Appeal decision, a small but growing number of experts have expressed concerns about the evidence presented at the trial. In a July article published by The Guardian, several experts expressed concern that Letby's conviction was not valid.
Of the 24 signatories to the letter, sent to Health Minister Wes Streeting and Justice Minister Shabana Mahmood last month, only seven experts have previously spoken publicly about their concerns.
This is the first time that other signatories, including Dr Tariq Ali, former head of paediatric intensive care at Oxford University Hospitals, and Philip Dawid, emeritus professor of statistics at Cambridge University, have publicly voiced their concerns.
Among those raising doubts about the Letby case are Jane Hutton, professor of statistics at the University of Warwick, Professor Gillian Tully, a leading expert in forensic science, and Dr Neil Ayton, a neonatologist and medical expert witness with more than 20 years' experience.
They described themselves as a “diverse group of doctors, nurses and scientists” that independently investigated the Letby case, but stressed that they were “not affiliated with Ms. Letby or her legal team, nor were we driven by an emotional reaction to the case. Our approach is rooted in scientific analysis and concerns about systemic problems within the health care and justice systems.”
“While we recognize the seriousness of the guilty verdict against Mr. Letby, our focus is on the broader implications, including patient safety, medical management and the possibility of wrongful convictions in complex medical cases. We believe the legal system is particularly prone to error when dealing with complex scientific evidence, especially cases involving statistical anomalies in medical settings and the complex physiology of newborns.”
Challenging one element of the Thirlwall inquiry that relates directly to Letby, they said the assumption made in the wake of a conviction – that she was the killer – “may result in a failure to understand and investigate alternative, potentially more complex causes of death and may result in important lessons being missed. The possibility of a death by negligence being presumed to be murder may result in an incomplete investigation of management's response to the crisis.”
The main hearings of the Thirlwall Inquiry are due to begin in Liverpool on September 10. Its remit will include investigating whether CoC management should have taken action earlier to prevent babies being killed in the neonatal unit at Letby Hospital.
The letter makes two proposals. The first is to suspend the public inquiry “to allow for further investigation and to hear a wide range of expert concerns”. The second is to change the inquiry's terms of reference to allow “a wider exploration of factors that may be contributing to the increase in neonatal deaths, without presuming criminal intent”.
The letter was signed by Dr Svirena Dimitrova, neonatology specialist adviser at the Care Quality Commission and member of the independent committee. Ockenden reviews Peter Elston, a member of the Royal Statistical Society who investigated the maternal and baby deaths at Nottingham University Hospital, questioned the analysis of shift data relied on by the prosecution ahead of the trial starting in October 2022.
The letter added: “We wish to emphasise that our aim is not to retry the Letby case but to enable the Thirlwall Inquiry to carry out the most thorough and beneficial investigation possible for the future of neonatal care in the UK.”
Other signatories include Professor Peter Green, former president of the Royal Statistical Society, Dr Neela Shabde, consultant paediatrician for North East England and former clinical director of child health, Jenny Harris, experienced neonatal intensive care nurse, and Professor Stephen Sen, former head of health statistics at the University of Glasgow.
The letter also said seven neonatal and paediatric specialists, two neonatal nurse specialists and two neonatal nurses shared their concerns but asked to remain anonymous for fear of repercussions.
The intervention comes as new questions are being raised about the accuracy of the evidence presented at Letby's trial. Prosecutors confirmed last week that door swipe data from CoC Hospital was inaccurate in showing Letby was alone when her baby collapsed. Police mistakenly thought the swipe data showed nurses leaving the newborn room to head to the delivery room, when in fact the nurses had returned to the newborn room.
In Letby's retrial for the attempted murder of Baby K, the prosecution corrected an error, overturning their original claim that Letby was alone at the time of the murder – in fact, another nurse who worked in the same room as Letby had returned. Child Protective Services declined to say whether they also needed to correct the swipe data they used in the original trial.
A government spokesman said the investigation would provide an opportunity to learn from events at the CoC: “This was a horrific incident and there were clear failings across the NHS and the regulator. The investigation will look at all aspects of the incident and its contents were agreed following extensive consultation with the commissioner, families affected and other stakeholders, including NHS England.”
A spokesman for the investigative committee said hearings would begin as scheduled on September 10 and would “follow the terms of inquiry set out by the Secretary of State.”
