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Letby deaths could have been prevented, inquiry finds; minister 'profoundly sorry'

An inquiry into nurse Lucy Letby's murders of seven babies has found a "complete failure" to protect infants at the Countess of Chester Hospital, with chair Kathryn Thirlwall saying some deaths could have been prevented.

Lucy Letby

Supporters of Lucy Letby gather outside the Thirwall Inquiry at Liverpool Town Hall on September 15, 2026 in Liverpool, England.

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  • Inquiry finds "complete failure" at hospital let Letby murder seven babies; some deaths preventable
  • Hospital trust apologises; minister Yvette Cooper "profoundly sorry" on behalf of government, NHS
  • Inquiry recommends cot cameras, stronger insulin safeguards and new NHS harm protocol
  • Three hospital managers remain under investigation for gross negligence manslaughter

NURSE Lucy Letby was able to murder seven babies because of a "complete failure" to protect infants at the hospital where she worked, and some of the deaths could have been prevented, the chair of an inquiry said on Tuesday.

Inquiry chair Kathryn Thirlwall criticised senior staff for not acting sooner, blaming dysfunctional management at the Countess of Chester Hospital, in northern England, and a basic lack of understanding of safeguarding.


"Once there was suspicion that Letby may be causing harm deliberately, safeguarding steps should have been taken," Thirlwall said as she delivered her final report. "No one seems to have thought that safeguarding action is required when a member of staff is suspected of causing deliberate harm. Suspicion is enough."

Thirlwall's report was particularly critical of senior executives and nursing leaders at the Countess of Chester Hospital, saying at least two of Letby's murders could have been prevented if action was taken sooner.

Lucy Letby Case : Experts Challenge Conviction Evidence

The Countess of Chester Hospital NHS Foundation Trust apologised and said it was now a different organisation with new leadership, while health minister Yvette Cooper said she was "profoundly sorry" on behalf of the British government and health service.

Letby, 36, was convicted in 2023 of murdering seven newborns and attempting to murder six others, making her Britain's most prolific serial child killer of modern times. She was later convicted of another attempted murder charge. Prosecutors said Letby attacked the newborns by giving them an overdose of insulin, injecting them with air or force-feeding them milk between June 2015 and June 2016, in a case that shocked Britain and drew worldwide attention. She was sentenced to life without parole and maintains she is innocent.

Thirlwall made a series of recommendations to improve neonatal services in the state-run National Health Service, calling on the government to tackle the "long-standing underfunding of hospital services for babies and children." She also suggested measures to protect patients, including fitting cots and incubators with cameras, stronger insulin storage safeguards and an NHS protocol for when staff are suspected to have deliberately harmed a patient.

Cooper told lawmakers she had asked officials to urgently develop plans for cameras in cots.

Richard Scorer, a lawyer at Slater and Gordon who represents three families, said Thirlwall's recommendations should be implemented without delay. "Far too often public inquiry recommendations are left to gather dust," he said.

Three senior hospital staff arrested in Lucy Letby case probe

Three senior hospital managers were arrested last year on suspicion of gross negligence manslaughter and remain under investigation, Cheshire Police said, with one of the three also suspected of perverting the course of justice. Evidence submitted by the force in support of further charges relating to Letby's time working at the Countess of Chester Hospital and Liverpool Women's Hospital was, however, deemed insufficient by prosecutors last year.

Letby has also been the subject of a growing campaign, backed by some medical experts and specialists, which has publicly questioned her convictions. Thirlwall did not address Letby's guilt or innocence in her report and emphasised the impact on those whose children were harmed, saying: "The families must not be collateral damage in the public argument about whether or not Letby is guilty."

The contents of her report will be pored over by those who assert Letby's innocence, around two dozen of whom gathered outside Liverpool Town Hall on Tuesday. It will also be examined by the Criminal Cases Review Commission, an independent body that reviews potential miscarriages of justice and is considering an application from Letby's legal team.

"This inquiry has proceeded on the wrong premise and it follows that this has inevitably affected the report as a whole," Letby's lawyer, Mark McDonald, said in a statement.

(With inputs from agencies)

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