Lucy Letby

Lucy Letby (born 4 January 1990) is a British former NHS neonatal nurse convicted of murdering seven babies and attempting to murder seven others at the Countess of Chester Hospital in Chester between June 2015 and June 2016. She was investigated after an unusual cluster of deaths in the hospital's neonatal unit.

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 at many of the incidents, two abnormal blood test results and skin discolouration interpreted as signs of insulin poisoning and air embolism, inconsistencies in medical records, her removal of nursing handover sheets from the hospital, and handwritten notes interpreted by the prosecution 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. The jury was unable to reach verdicts on six further counts. She received fourteen whole life orders, meaning life imprisonment without the possibility of parole. One of the unresolved attempted murder charges was retried in July 2024, resulting in a fifteenth whole life order.

The senior management of the Countess of Chester Hospital was criticised for failing to act on clinicians' concerns, prompting the British government to commission an independent inquiry. Cheshire Police examined extra cases, resulting in three arrests related to corporate manslaughter.

Two applications for permission to appeal have been refused by the Court of Appeal. Multiple experts have since challenged the prosecution's interpretation of the medical evidence, arguing that the infants' deaths were explainable by natural causes. The Criminal Cases Review Commission is considering referring the case back to the Court of Appeal.

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,

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

Career Letby began working as a registered nurse in the neonatal unit at the Countess of Chester Hospital on 2 January 2012. Colleagues later recalled that she sometimes described non‑intensive care work as boring. She completed another specialisation course in March 2014 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, consultant paediatrician and neonatal-unit lead clinician Stephen Brearey asked hospital management to remove Letby from clinical duties pending an investigation.

After an interim suspension in 2020, the Nursing and Midwifery Council struck off Letby's registration on 12 December 2023 after her conviction. Letby had informed the council that she did not accept guilt but would not contest her removal.

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. Subsequent reporting in 2023 indicated that he had developed suspicions earlier and believed the trust failed to act on them. 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. and later said that she had not been "adequately briefed" about the concerns about Letby before she carried out her analysis.

Letby lodged a formal grievance in September 2016 regarding her removal from clinical duties.

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, The resulting investigation was named Operation Hummingbird. 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 4 October 2022 before Mr Justice Goss. She pleaded not guilty to seven counts of murder and 15 counts of attempted murder.

The infants were anonymised as Baby A to Baby Q. Two years before the trial, Mrs Justice Steyn had ordered that the surviving infants could not be identified until adulthood. Several adult witnesses were also granted anonymity, which the court considered necessary to secure their testimony. Baby E died later that day. The court also heard that she had been advised more than once not to enter a room where bereaved parents were grieving.

Prosecutors cited text messages sent by Letby to colleagues, which they said showed inappropriate interest in clinical events. The court also heard that Letby had searched for the families of several infants on Facebook, She told the jury this reflected general curiosity and frequent phone use. and that the pattern of collapses shifted after she was moved from night to day shifts in 2016. Their lead expert witness described this as key evidence, though their interpretation has since been questioned by some specialists. The prosecution also argued that Baby M, the twin of Baby L, collapsed after air was injected into his bloodstream.

Several consultants told the court they had previously raised concerns about Letby but were discouraged by hospital managers. One doctor recalled Letby making a remark shortly before an infant's death that he interpreted as inappropriate. The prosecution also presented a shift‑pattern chart showing Letby on duty for 25 incidents, supported by swipe‑card data. The chart has since been criticised by some statisticians as misleading.

Handwritten notes Police searches of Letby's home and her handbag recovered several handwritten notes containing statements including "I killed them on purpose because I'm not good enough to care for them", "I am evil I did this", but also phrases such as "I haven't done anything wrong". The prosecution characterised some of the phrases as incriminating, while the defence said they reflected emotional turmoil during employment disputes and the stress of being removed from clinical duties.

Medical records

Police searches of Letby's home recovered sensitive medical documents, including nursing handover sheets, resuscitation records and blood‑gas printouts. Letby told the court that she often forgot to remove paperwork from her pockets after shifts and described herself as someone who "collect[ed] paper". She also said she had been unable to destroy the documents, although a paper shredder was found in her home. She told the court that the allegations had severely affected her mental health and left her feeling isolated from colleagues. Reporting from the trial noted that she sometimes contradicted herself, became confused about aspects of her account and grew increasingly frustrated during cross‑examination, which observers contrasted with her usual calm presentation. The defence also suggested that "extraordinary bleeding" in one infant might have been caused by medical equipment rather than deliberate injury.

Counsel for the defence maintained that the prosecution had not presented sufficient evidence to support its theories of how the infants were harmed. They argued that the evidence for air embolism was too weak to sustain the allegation and noted that the term did not appear in Letby's internet search history. No independent medical experts were called by the defence.

The defence submitted that there was no case to answer on the air‑embolism allegations, arguing that the prosecution's experts lacked sufficient clinical experience, that the research basis for air embolism was inconsistent, and that expert descriptions of the condition varied. +Convictions from the first trial Count Baby Charge Date of death/collapse Mechanism Gestational age (weeks) Birth weight (kg) Age at death 1 A Murder 8 June 2015 Air embolus 31 24 hours 2 B Attempted murder 9/10 June 2015 Air embolus 31 37

0.97 In his remarks, Goss described her actions as "a cruel, calculated and cynical campaign of child murder involving the smallest and most vulnerable of children", adding that "there was a deep malevolence bordering on sadism [...] you [Letby] have no remorse [...] there are no mitigating factors [...] the offences are of sufficient severity to require a whole life order."

Letby chose not to attend the sentencing hearing and therefore did not hear the victim impact statements or the sentence being passed. On 30 August 2023, Prime Minister Rishi Sunak announced plans to introduce legislation enabling courts to compel attendance, including by force, or impose additional prison time for refusal. A clause to this effect was later proposed during parliamentary consideration of the criminal justice bill in 2024.

Following the trial, Letby was transferred to HMP Low Newton in County Durham. , she is held at HM Prison Bronzefield.

Motive No motive was established in court, and none is required for a conviction. Prosecutors suggested several possible explanations, including boredom, thrill‑seeking and "playing God". They also stated that Letby had formed an inappropriate emotional attachment to a married doctor involved in some of the cases, citing frequent text exchanges and a note found in her home containing phrases such as "I trusted you with everything and loved you", "You were my best friend" and "Please help me". Letby denied that she had a relationship with, or feelings for, the doctor.

Commentators drew comparisons with the Beverley Allitt case. The former detective who led the Allitt investigation suggested that Letby might have imitated Allitt's methods. Criminal psychologists Dominic Wilmott and David Holmes proposed that Letby could have been motivated by factitious disorder imposed on another, a theory also raised in relation to Allitt. 31:15 David Wilson, an emeritus professor of criminology, argued in an August 2023 opinion piece that Letby was driven by a "hero complex".

Post-conviction

Appeal In January 2024, Letby applied to the Court of Appeal for permission to challenge her convictions, but this was refused by a single judge. She renewed her application, and at a three‑day hearing in April 2024 her legal team advanced four grounds of appeal relating to the trial judge's rulings. In May 2024, a panel comprising Dame Victoria Sharp, Lord Justice Holroyde and Mrs Justice Lambert refused permission to appeal.

As part of the appeal, Letby's counsel, Ben Myers, again challenged the admission of evidence from paediatrician Evans, arguing that it should have been excluded on the basis that Evans had been "dogmatic and biased". The appeal judges rejected this, finding that Evans did not lack impartiality, was suitably qualified to give expert evidence, and that it was for the jury to assess its weight.

The retrial began on 10 June 2024. On 2 July, Letby was found guilty of attempted murder, and on 5 July she received a further whole‑life order.

On 24 October 2024, Letby applied for permission to appeal this conviction, arguing that prejudicial media coverage should have prevented the trial from proceeding. The Court of Appeal rejected the application.

Further investigations and arrests Following the verdict, police continued to investigate whether Letby had harmed other infants. Detectives reviewed around 30 cases at the Countess of Chester Hospital that had been identified as "suspicious". Neonatologists examined approximately 4,000 admissions at that hospital, where Letby had worked from 2012, and at Liverpool Women's Hospital, where she had completed two placements in 2012 and 2015, and were asked to refer any "unexpected and unexplained" deteriorations to police. At least one family was informed that their child's case at Liverpool Women's Hospital formed part of the inquiry. Cheshire Police interviewed Letby under caution in relation to deaths at both hospitals. On 2 July 2025, the Crown Prosecution Service confirmed that it was considering further charges based on new evidence provided by the police.

On 4 October 2023, Cheshire Constabulary announced an investigation into potential corporate manslaughter at the Countess of Chester Hospital. On 1 July 2025, three members of the hospital's former senior leadership team were arrested on suspicion of gross negligence manslaughter. On 23 April 2026 one of the three was arrested and bailed for perverting the course of justice.

On 20 January 2026, after reviewing evidence relating to allegations of murder involving two children and attempted murder involving seven others, the Crown Prosecution Service announced that no further charges would be brought against Letby.

Thirlwall Inquiry After Letby's conviction, the British government announced an independent inquiry into "the circumstances surrounding the deaths and incidents, including how concerns raised by clinicians were dealt with". It was initially established on a non‑statutory basis, meaning witnesses could not be compelled to give evidence and inquests would still be required. Senior figures at the Countess of Chester Hospital, including the medical director, chief executive and nursing director at the time of the incidents, said they would cooperate. Chester MP Samantha Dixon, Steve Brine, chair of the Health and Social Care Select Committee, Sir Keir Starmer, then Leader of the Opposition, and the Parliamentary and Health Service Ombudsman.

In August 2024, a group of 24 neonatal and statistical experts wrote to ministers requesting that the inquiry be postponed and its terms amended, citing concerns about the safety of Letby's convictions. The inquiry declined to make changes.

Education Secretary Gillian Keegan said the type of inquiry would be reviewed once a chair was appointed. On 30 August 2023, Health Secretary Steve Barclay announced that it would be upgraded to a statutory inquiry, enabling witnesses to be compelled to give evidence.

The inquiry, chaired by Lady Justice Thirlwall, formally opened on 22 November 2023. The public hearings began on 10 September 2024. In a ruling on 29 May 2024, the chair determined that remote live viewing would be available to Core Participants, their legal representatives and the media, but not to the wider public. During the hearings, colleagues gave evidence describing Letby as "excited and gossipy" when discussing the death of an infant, saying she preferred caring for unwell babies, complained when moved to less acute areas, and expressed eagerness for the first death of an infant to "get it out of the way".

Former Health Secretary Jeremy Hunt apologised to families during the 2025 hearings, saying the government had taken "too long" to act.

Letby's lawyers and other supporters later asked for the inquiry to be paused while her application to the Criminal Cases Review Commission was considered. Thirlwall rejected the request in March 2025 and said she intended to deliver her report in November 2025.

After delays, in April 2026, Lady Justice Thirwall confirmed that work on the report was still ongoing and a publication date cannot be confirmed.

New defence team In September 2024, Letby appointed a new defence lawyer, Mark McDonald. At a press conference in December 2024, McDonald said he was preparing fresh applications to both the Court of Appeal and the Criminal Cases Review Commission. He argued that the prosecution's lead expert witness, Dewi Evans, was unreliable, claiming that Evans had altered his views on how some infants had died. McDonald also said that several experts were producing reports on the infants' deaths without payment, and that two reports—relating to Children C and O—had concluded that there was no evidence of deliberate harm.

Following the press conference, Evans rejected the criticisms, describing them as "unsubstantiated, unfounded, inaccurate". He said the only change in his evidence concerned the date of Child C's death, which he attributed to a clerical error by the prosecution. Some of Evans's post‑trial comments about the mechanisms of death differed from positions he had taken while giving evidence at trial.

On 4 February 2025, Letby's legal team applied for her case to be reviewed as a potential miscarriage of justice. On the same day, findings from a panel of 14 international medical experts were released. Chaired by Shoo Lee, a retired neonatologist from the University of Toronto, the panel concluded that there was no medical evidence supporting claims that Letby had deliberately harmed or murdered infants at the Countess of Chester Hospital. The panel attributed many of the deaths to natural causes or substandard care, citing issues such as inadequate staffing and delays in essential treatment, and argued that the deaths were unrelated to deliberate actions by Letby.

Inquests Inquests into the deaths of five babies were opened on 4 February 2026. English law limits the verdicts available to coroners when criminal convictions have already been returned. A neonatal consultant who had raised concerns about Letby also urged the introduction of regulation for healthcare management.

The Parliamentary and Health Service Ombudsman, Rob Behrens, said that radical reform of NHS management was needed to prevent similar failures. Dewi Evans called for an investigation into potential corporate manslaughter in relation to the case. Dame Ruth May, NHS England's Chief Nursing Officer, stated that the NHS was committed to learning from the case and welcomed the independent inquiry announced by the Department of Health and Social Care.

On 21 August 2023, it was announced that the nursing director at the Countess of Chester Hospital during Letby's employment had been suspended from her subsequent role at Northern Care Alliance NHS Foundation Trust, following information that emerged during the trial. She and other senior executives at the hospital were accused of failing to act on warnings about Letby.

Expert reviews of the evidence

Letby has maintained that she is innocent of the offences for which she was convicted. Following the trials, a number of medical, statistical and other scientific experts have criticised the prosecution's evidence. The defence have been criticised for failing to call any of their own expert witnesses at trial. Controversy has also arisen from the fact that the original post‑mortem reports for the infants—most of whom underwent autopsy—did not identify suspicious or unnatural causes of death.

In February 2025, a panel of 14 international experts convened by neonatologist Shoo Lee released findings from their own review of the deaths and collapses . The panel concluded that all of the incidents could be explained by natural causes, substandard care, or a combination of both, and found no evidence of deliberate harm.

The following subsections summarise some of the concerns raised by the Lee panel and other experts.

Insulin Experts have questioned the interpretation of blood test results used to support the allegation that Letby poisoned two infants with insulin.

Other experts have suggested that, even if accurate, the results may have alternative explanations.

A separate report by seven experts, including neonatologists, a forensic toxicologist, a forensic scientist and a paediatric endocrinologist, also raised concerns about the reliability of the assay, argued that the prosecution inappropriately relied on studies involving adults and older children, and highlighted alternative explanations for the infants' hypoglycaemia. Both reports have been submitted to the Criminal Cases Review Commission. A different paediatric endocrinologist, John Gregory, has supported the prosecution's interpretation that the results were consistent with insulin administration.

Air via nasogastric tube Several neonatologists have described the allegation that Letby murdered three infants by injecting air into their stomachs via a nasogastric tube as implausible, variously calling the theory "nonsensical", "ridiculous", "fantastical" and "not practically feasible".

After the trials, the prosecution's lead expert witness, Dewi Evans, said he no longer agreed with the prosecution's account of how Child C died and no longer believed that any of the infants were killed "as a direct result" of air injected into their stomachs. The Lee panel concluded that there was no evidence that air had been forced down any infant's nasogastric tube.

Air embolism The prosecution cited a 1989 study by Shoo Lee and A. K. Tanswell to argue that skin discolouration observed on some infants was indicative of air embolism. After reviewing the descriptions of the discolouration, Lee said he did not consider them suggestive of air embolism and described diagnosing the condition by ruling out other causes as "a fundamental mistake of medicine". The defence sought to call Lee as an expert witness during an appeal in 2024, but the Court of Appeal ruled his evidence inadmissible on the basis that he could have been called at trial and that the prosecution had not relied solely on skin discolouration to support the diagnosis. Abid Qazi, a former NHS paediatric surgeon whose case report was cited in a prosecution expert's analysis, reviewed one of the cases and expressed scepticism about the diagnosis, saying he believed Letby had been "a victim of the poor NHS system". The prosecution pathologist and an independent expert interviewed by the BBC both said there was no evidence of needle trauma, although the BBC's expert also considered deliberate harm "unlikely".

The Lee panel concluded that the doctor's needle may have penetrated the liver but considered it "highly likely" that the initial injury resulted from a traumatic delivery. They described the prosecution's blunt-force trauma hypothesis as "implausible". Neonatologist Mike Hall, who was instructed by Letby's first defence team but not called to testify, disputed the panel's traumatic‑delivery explanation but maintained that there was no evidence of deliberate harm. The Lee panel argued that there was no evidence the tube had been displaced and that the infant's deterioration was instead caused by the tube being too small.

Quality of the statistical evidence Several statisticians have criticised the prosecution's use of data. The prosecution has been accused of relying on reasoning comparable to the Texas sharpshooter fallacy and the prosecutor's fallacy. A shift chart presented to the jury, which appeared to place Letby at every suspicious incident, has been challenged on the grounds that the criteria for selecting incidents were unclear and potentially biased. Critics highlight, for instance, that some deaths and other incidents were left out, that non‑nursing staff were not included, and that the chart lacked contextual information such as relative shift frequency. and have proposed alternative explanations for the rise in mortality.

During the investigation, Cheshire Police contacted Jane Hutton, a medical statistician, and signed a consultancy agreement with her. Before she could conduct her analysis, the police cancelled this agreement and line of inquiry, citing instructions from the Crown Prosecution Service. After the trials, Hutton became one of the experts publicly critical of the statistical evidence, arguing that it "does not hold water".

Staff and infrastructure issues In May 2024, The New Yorker published a feature article by staff writer Rachel Aviv that questioned aspects of Letby's conviction. Aviv highlighted chronic staffing shortages on the unit, noting that staff were "overtaxed" and that only one specialist neonatologist was available. She also referred to hygiene concerns, including an earlier inquest finding that an infant had died in 2014 after a breathing tube was inserted incorrectly, and drainage problems that caused blocked pipes and occasional sewage backflow in sinks, issues that had been raised by the defence at trial. a decision questioned in Parliament by Conservative MP David Davis.

In August 2024, a leaked report revealed that the unit had experienced an outbreak of a dangerous bacterium during the period in which the infants Letby was convicted of murdering died. The outbreak had not been mentioned during the trials. Commenting on the report, medical microbiologist David Livermore argued that the outbreak offered a simpler explanation for the rise in deaths than deliberate harm.

Mislabelled door swipe data During the first trial, door swipe records were used to establish Letby's presence on the neonatal unit at the time of various incidents. Cheshire Police reviewed the use of the incorrect data and concluded that it had been relied upon in evidence relating to nine infants, although it played a central role only in the case of Child K, for whom Letby was not convicted at the first trial.

Criticism of expert witnesses Several medical experts have questioned the reliability of the prosecution's expert witness, Dewi Evans. Svilena Dimitrova, an NHS consultant neonatologist, and Roger Norwich, a medico-legal expert, submitted formal complaints to the General Medical Council regarding Evans's evidence. Dimitrova told The Guardian that she believed "the theories proposed in court were not plausible and the prosecution was full of medical inaccuracies", adding that while she could not assert Letby's innocence, she saw "no proof of guilt". Evans rejected suggestions of bias and noted that the defence could have called its own expert witnesses at trial but did not do so. Other prosecution experts broadly supported Evans' conclusions.

The prosecution's endocrinologist, Peter Hindmarsh, was under investigation by the General Medical Council (GMC) when he gave evidence during the trial. The investigation was prompted by "multiple and wide-ranging concerns" about his practice from both of the hospitals he was affiliated with. A medical tribunal placed restrictions on his ability to practise, arguing that he "may pose a real risk to members of the public". The jury were not told about the investigation or related concerns. Hindmarsh's testimony was central to the insulin cases. He removed himself from the GMC register in 2024, ending the investigation before its conclusion.

Reaction and responses to doubt Evans has said he has received online abuse from supporters of Letby who question the safety of her convictions. He argued that some people struggle to accept that a perpetrator could be "a young, white, English nurse from a respectable background", citing the examples of Harold Shipman and Jimmy Savile for how an outward appearance of being "normal" had aided in hiding crimes.

BBC special correspondent Judith Moritz, one of four reporters permitted in the courtroom, told The Sunday Times that public debate about the case often overlooked the jury's experience of observing Letby. Moritz said Letby appeared tearful when discussing herself, her job loss and the testifying in court by a married doctor with whom she had exchanged numerous Facebook messages, but not "particularly" affected when the infants' deaths were discussed. Moritz also said that Letby contradicted herself and attempted to "out-lawyer" the prosecutor. Some courtroom observers during the first trial described Letby as "aloof and indifferent" and noted her frequent claims of having no recollection of events, which they felt contributed to an impression of guilt.

Expert panel investigation During Letby's 2022–2023 trial, the prosecution's expert witness, Dewi Evans, relied on a 1989 article by Canadian neonatologist Shoo Lee to support a diagnosis of air embolism as the mechanism of death in several cases. Lee was not called as a witness and, living in Canada, did not learn that his research had been used in the trial until after the verdict. On becoming aware of the case, he expressed concern that his work had been misapplied.

Following Letby's unsuccessful application for leave to appeal in 2024, Lee convened a panel of 14 medical experts from six countries to review all of the cases from the trials. The panel was provided with medical records and relevant witness testimony by Letby's barrister. Members accepted no payment and agreed to publish their findings regardless of whether they supported or undermined the convictions. Lee stated that the panel "did not find any murders" and concluded that "in all cases, death or injury were due to natural causes or just bad medical care". In parallel, Letby's legal team submitted an application to the Criminal Cases Review Commission for the case to be reviewed as a potential miscarriage of justice. In 2024, Channel 5 released two documentaries Lucy Letby: Did She Really Do It? and Letby: The New Evidence. That same year, Moritz and Jonathan Coffey published Unmasking Lucy Letby: The Untold Story of the Killer Nurse. In 2025, ITV broadcast Lucy Letby: Beyond Reasonable Doubt?, while Channel 4 aired two series: Conviction: The Case of Lucy Letby and Lucy Letby: Murder or Mistake. In 2026, Netflix released a feature-length documentary titled The Investigation of Lucy Letby.