Lucy Letby, a former neonatal nurse at the Countess of Chester Hospital, was convicted in 2023 of murdering seven babies and attempting to murder six others between 2015 and 2016. She was sentenced to 14 whole life terms, and a further retrial in 2024 resulted in another guilty verdict, bringing the total to 15. Her convictions followed a lengthy investigation and trial based largely on medical records and expert testimony.

However, since the verdicts, a growing number of medical professionals and legal commentators have raised concerns about the strength of the evidence used to convict her. An international panel of neonatal experts, including Canadian Professor Shoo Lee and British neonatologist Dr Richard Taylor, have reviewed the case and concluded that the deaths could be explained by natural causes, medical failings, or a combination of both. Their findings have been submitted to the Criminal Cases Review Commission (CCRC), which has the power to refer the case back to the Court of Appeal. However, the UK’s Crown Prosecution Service (CPS) maintains that the convictions were based on expert evidence and a thorough investigation. Meanwhile, detectives investigating Letby have passed evidence of further allegations related to baby deaths and collapses at the hospitals where she worked. The allegations are now being considered by lawyers at the CPS. She continues to serve 15 whole life sentences.

In the column below, KEITH WILKINSON – a retired consultant anaesthetist who worked at Noble’s Hospital for three decades and author of Manx Murders – offers his personal perspective on the case, based on his own medical experience and independent review of the material presented at trial...

The death penalty was abolished in the UK in 1965, but it remained in place on the Isle of Man until 1993. While no executions were carried out during that time, several men were sentenced to death before their penalties were commuted to life imprisonment. Since 1983, the most severe sentence in murder cases has been the ‘whole life order’, used in the most serious circumstances.

One such sentence was handed down in 2023 to Lucy Letby, a former neonatal nurse found guilty of the murder and attempted murder of multiple babies at the Countess of Chester Hospital. Following a retrial in 2024, she now faces 15 whole life sentences.

Like many others, I followed this case closely. As a retired anaesthetist with 37 years of experience – 30 of those at Noble’s Hospital – I have long taken an interest in medical and legal matters, including miscarriages of justice. Over the years I’ve followed the cases of the Birmingham Six, the Guildford Four, and others whose convictions were later overturned.

Initially, I assumed Lucy Letby was guilty. But over time, I began to explore the details of the case in more depth – reading trial transcripts, attending some of the Thirlwall Inquiry, and reviewing commentary from legal and medical experts. This led me to develop serious concerns about whether the full picture was presented during the trial.

Letby’s conviction was based on circumstantial evidence; no one witnessed her harming a baby. Prior to the period in question, she had worked without concern and had recently completed specialist training. The case against her emerged after a rise in infant collapses and deaths on the ward, with some doctors noting she was present during several incidents.

Initial reviews by outside experts – including those commissioned by the hospital – reportedly did not find evidence of deliberate harm. An internal grievance Letby filed against consultants in 2016 was upheld, and a senior staff member at the time expressed doubts about the conduct of those making the allegations. However, concerns persisted, and in 2017 police began a criminal investigation that led to Letby’s eventual arrest and prosecution.

The prosecution’s case relied heavily on expert testimony, particularly from Dr Dewi Evans, who had not practiced clinically since 2009 but had worked extensively as an expert witness. After reviewing the case notes, he concluded that babies had been harmed in a variety of ways. Some had air injected either into the circulation (air embolism) or into the stomach via a feeding tube to distend it and compromise breathing. Others, he said, were given insulin and one had suffered deliberate trauma to the liver. Another expert, Dr Sandy Bohin, supported these views.

More recently, some of these conclusions have been challenged. A number of professionals – including MP David Davis, neonatologists such as Dr Richard Taylor, and Canadian Professor Shoo Lee – have expressed concern over the interpretation of the medical evidence. An international panel convened by Dr Lee concluded that the deaths could be attributed to natural causes, medical failings, or a combination of both. Their report has been submitted to the CCRC (Criminal Cases Review Commission), which reviews potential miscarriages of justice and can send such cases back to the Court of Appeal.

Concerns have also been raised about elements of the trial process. For example, Letby’s defence team did not call expert medical witnesses, and some material – such as her successful grievance – was not presented to the jury. There are also questions about whether the retrial jury was prejudiced by awareness of the earlier convictions.

Supporters of Letby, including medical professionals and campaign groups such as ‘Nineteen Nurses’, have called for the case to be reviewed. I recently attended one of their meetings in Hereford, where I heard from experts and Letby’s supporters, some of whom argue the case represents a serious miscarriage of justice. A friend of Lucy's, who didn’t wish to be named, spoke at the meeting, as reported by [Welsh news website] Nation.Cymru. She said: ‘The media had already fabricated the most abhorrent monster that they could conjure before Lucy was even found guilty. During the trial, everyone who knew Lucy was silenced by fear of recrimination if we spoke out in her defence... And what the world saw as a story of a killer nurse on the ward unfolding, I knew in reality was one of the worst miscarriages of justice in the UK today.’

I recognise that this is a highly sensitive matter, particularly for the families of the babies involved. Nothing I say is intended to diminish their loss. However, I believe it is vital in any society that convictions – especially those resulting in life-long imprisonment – are open to scrutiny when substantial new evidence or expert concerns arise.

My hope is that the Criminal Cases Review Commission will assess the available information and determine whether the case should return to the Court of Appeal. Whatever the outcome, it is the pursuit of truth and justice that must remain at the heart of this process.