Thirlwall Inquiry reveals Letby's pattern of deception and callousness toward families

Lucy Letby, now 36, is serving fifteen whole-life prison sentences after being convicted of murdering seven babies and attempting to murder seven others at the Countess of Chester Hospital's neonatal unit between 2015 and 2016. She remains Britain's most prolific child killer in legal history. A public inquiry led by Lady Justice Thirlwall, published this week, has now documented in granular detail not just what Letby did, but who she was while doing it—a portrait of deception, insubordination, and a coldness toward the families whose children died in her care.

The inquiry was not tasked with determining Letby's guilt; she has already been convicted and maintains her innocence. Instead, Thirlwall examined how the hospital handled concerns about the neonatal nurse and whether earlier intervention could have stopped her. The investigation concluded that some of the deaths and near-deaths could have been prevented had proper safeguarding procedures been followed. But the report also reconstructs Letby's behavior in the unit with uncomfortable specificity, drawing on testimony from colleagues, families, and her own documented actions.

One incident illustrates her pattern of disregarding instruction. After Baby C died, Letby was observed helping to make a memory box for the infant's parents—a task she had not been assigned and was actively told not to do. Baby C's mother told the inquiry that Letby had been directed to care for a different child but repeatedly abandoned that assignment to involve herself with Baby C. Thirlwall noted that management took no action when Letby ignored these directions. The pattern extended beyond this single case: Letby ignored management instructions when she disagreed with them and had shouted at her manager.

Thirlwall found Letby was "repeatedly untruthful in her dealings with friends and colleagues." One documented instance involved a message Letby sent to a colleague after Baby A's death. She wrote that the father had been found on the floor crying, pleading not to have his baby taken away when Letby brought the body to the mortuary. The mother of Baby A and Baby B—the latter of whom Letby attempted to murder—told the inquiry this account was false and never occurred. Thirlwall agreed with the mother's assessment that the message was "attention seeking" and constituted a "red flag."

The inquiry also documented Letby's callousness toward bereaved families. When the mother of Baby E, whom Letby murdered, and Baby F, whom she attempted to kill, found her dead baby still in the incubator and asked Letby why, Letby responded: "You haven't told us to take him." Thirlwall described this remark to a grieving mother as "shockingly cold and unfeeling." The mother had told the inquiry that she had possessed "two thriving little boys" but that "in the space of a couple of hours it had all been taken." Letby also falsified Baby E's medical record, omitting the infant's distress, blood from the baby's mouth, and the mother's visit to the unit. In another case, Baby J was found covered in their own faeces while in Letby's care, prompting a formal complaint from the parents.

Letby's professional history showed mixed performance. Early assessments during her nursing training identified gaps in enthusiasm, communication with families, and drug calculations. By her second and third years, one nurse described her as "one of the best students she had mentored." But during her final placement, significant concerns emerged. The deputy ward manager noted that Letby was "quiet, withdrawn and struggled to build relationships with children, families and colleagues." She failed a mid-year assessment and an observed structured clinical examination, though she later passed the examination and qualified as a registered children's nurse in 2011.

Letby, from Hereford, has twice been denied permission to appeal her convictions in 2024 and continues to maintain her innocence. The Criminal Cases Review Commission, which investigates potential miscarriages of justice, is currently examining evidence presented on her behalf by an international panel of medical experts who argue that poor medical care and natural causes, rather than deliberate harm, explain the babies' collapses. Before Thirlwall delivered her findings, supporters of Letby gathered outside Liverpool Town Hall calling for her release.