Image source, Cheshire PoliceImage caption, Letby was convicted of the murders of seven babies and the attempted murder of seven others
New details have emerged about Lucy Letby, the killer neonatal nurse whose name can evoke both staunch support and unequivocal disgust.
Letby, now 36, is serving 15 whole-life prison terms after being convicted of murdering seven babies and attempting to murder seven others, including one baby whom she tried to murder twice.
In a lengthy report, published by Lady Justice Thirlwall earlier, she described how Letby was "repeatedly untruthful in her dealings with friends and colleagues" and "her inappropriate and callous nature was noted by patients and colleagues".
The Thirlwall Inquiry was set up to look into what happened at the Countess of Chester Hospital between 2015 and 2016, while Letby was working as a nurse in the neonatal unit.
The public inquiry was not tasked with examining Letby's guilt.
Instead, it investigated how concerns about the neonatal nurse were handled by the hospital and whether action could have been taken sooner to stop her.
Thirlwall found the deaths and near-deaths of some babies who were attacked by Letby could have been prevented if safeguarding practices had been followed.
But the inquiry report has also shed more details on Letby herself - the most prolific child killer in British legal history, who has always maintained her innocence.
Image source, Cheshire PoliceImage caption, The inquiry looked into the actions of managers at the hospital where Lucy Letby worked
Following the death of Baby C, Letby was observed helping to make a memory box with another nurse on the neonatal unit for the infant's parents.
However, Letby had not been asked to carry out this task and was "supposed to be somewhere else and was repeatedly told to be looking after a different child," Baby C's mother told the inquiry.
Thirlwall noted how "nothing was done about Letby repeatedly ignoring directions from the shift leader and leaving the other child [who she was designated to care for] to intervene with Baby C".
She found Letby ignored management instructions when she disliked them and had shouted at her manager.
Baby 'cot cams' plan after inquiry finds Lucy Letby crimes could have been prevented
Letby was also repeatedly untruthful in her dealing with friends and colleagues, the inquiry found.
This included lying about the reaction of the father of Baby A and Baby B, following Baby A's death.
In a message to a colleague, Letby said: "Dad was on the floor crying saying please don't take our baby away when I took [Baby A] to the mortuary, it's heart-breaking."
Thirlwall said the mother of Baby A and Baby B, who Letby attempted to murder, was clear that this was not true and did not happen.
"In her view, Letby's messages were 'attention seeking' and a 'red flag'. I agree," Thirlwall noted in the inquiry report.
Throughout her training as a nurse, feedback of Letby's performance in the work place was mixed, the inquiry found.
Early assessments pointed out areas for improvements, particularly in relation to enthusiasm, communication with families and drug calculations.
But academically her personal tutor reported no concerns.
While during her second and third years, she was described by a nurse as "one of the best students she had mentored", however, during her final placement "significant concerns were raised".
The deputy ward manager described Letby as "quiet, withdrawn and struggled to build relationships with children, families and colleagues".
Letby failed a mid-year assessment and observed structured clinical examination (OSCE).
She later passed this examination and qualified as a registered children's nurse in 2011.
But Thirlwall outlined how Letby's "inappropriate and callous behaviour" was noted by patients and colleagues.
The mother, for example, of Baby E, who Letby murdered, and Baby F, who she attempted to kill, told the inquiry she had had "two thriving little boys" but that "in the space of a couple of hours it had all been taken".
After Baby E's death, the mother told the inquiry she found her baby was still in his incubator, and she asked Letby why.
"You haven't told us to take him," she says Letby told her.
Thirlwall said Letby's remark to a "bereaved mother was shockingly cold and unfeeling."
Image source, PA MediaImage caption, Lady Justice Thirlwall oversaw the inquiry into the Lucy Letby case
The inquiry also found how Letby falsified Baby E's medical record.
Thirlwall noted how Letby omitted Baby E's distress and the blood on the baby's mouth from her notes.
She also failed to record the baby's mother's visit to the neonatal unit.
While in Letby's care, Baby J was also found covered in their own faeces, leading to a complaint by the baby's parents.
Letby, from Hereford, who maintains her innocence, has twice been denied permission in 2024 to appeal against her convictions.
The Criminal Cases Review Commission (CCRC), which investigates potential miscarriages of justice, is considering evidence presented on her behalf by an international panel of medics, who claim poor medical care and natural causes were the reasons for the babies collapsing.
A number of Letby supporters gathered outside Liverpool Town Hall to voice their concerns over her conviction, calling for her release, before Thirlwall delivered her inquiry findings.
Letby Hospital: Maternity failings at the Countess of Chester
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