The deaths and near-deaths of some babies who were attacked by nurse Lucy Letby could have been prevented if safeguarding practices had been followed, the public inquiry into her crimes has found.
Delivering the conclusion of her inquiry, chairwoman Lady Justice Thirlwall said it would never be possible to know for sure how many lives could have been saved.
But she found there was a “complete failure to protect babies on the neonatal unit” at the Countess of Chester Hospital, where Letby, now 36, murdered seven babies and attempted to murder seven others – one of them twice.
Thirlwall described a system of “dysfunctional management and governance”.
Letby was sentenced to 14 whole life terms in 2023 and received another in 2024 after a retrial found her guilty of one of the attempted murder counts the original jury had been unable to reach a verdict on.
Thirlwall said: “If all the babies whom [Letby] was convicted of murdering were removed from the annual number of deaths in the neonatal unit, the mortality figures would have been three in 2015 and three in 2016 – broadly consistent with previous years,” she wrote.
“Since July 2016 there has been one death on the unit, in Sept 2019.”
Below are the key findings from the report.