Inquiry finds failures allowed Lucy Letby crimes to continue

An inquiry into nurse Lucy Letby's crimes has revealed serious failures in hospital management and safeguarding practices that allowed harm to babies to continue unchecked. The findings expose a dysfunctional system that did not act despite warning signs, according to the report released on September 15.

The inquiry found that no connection was made by any of the people involved to earlier deaths, which was surprising given the circumstances. It described a complete failure to protect babies in the neonatal unit, with dysfunctional management and governance contributing to the ongoing harm.

The report criticised the handling of concerns as high-handed, against safeguarding principles, and foolhardy. It noted that those responsible sought to control the narrative rather than address the issues. The director of nursing for urgent care, Karen Rees, was affected by the view that Letby was a very good nurse, which contributed to the failure to act.

Staff were kept in the dark for years about the seriousness of the situation. The inquiry emphasised that the issue was never about nurses against doctors but about keeping babies safe. It condemned the way grievances and their consequences were handled as deplorable.

The inquiry also found that the investigation could bring neither independence nor objectivity to the process. It described some official responses as factually inaccurate and misleading. Initially, the allegations against Letby were downplayed, and no one seemed to understand that safeguarding action is required when a staff member is suspected of deliberate harm, without needing colleagues to be sure of guilt.

The report highlighted that those to whom concerns were expressed did nothing, allowing the crimes to continue. As a result, the inquiry recommended measures such as installing baby 'cot cams' to prevent similar incidents in the future.