Letby insisted on returning to neonatal unit, inquiry hears

A public inquiry has been informed that Lucy Letby informed a consultant paediatrician of her intention to return to the neonatal unit at the Countess of Chester Hospital, stating it would happen “whether you liked it or not”. Dr. Ravi Jayaram testified that Letby uttered this remark during a “bizarre” meeting held in late March 2017. This occurred mere days prior to what he understood as NHS management’s arrangement for her supervised re-entry to the unit. Letby had been reassigned to administrative tasks in July 2016. This followed a warning from all seven consultants in the unit to executives, expressing concerns that she might be intentionally harming infants, subsequent to a sequence of sudden and inexplicable deaths and collapses. Dr. Jayaram recounted to the inquiry, “She said she was coming back next week whether I liked it or not and would I be happy working with her.” The inquiry was informed that Letby had initiated a grievance procedure concerning her relocation from the neonatal unit. Allegations were made that junior doctors had referred to an unidentified nurse as an “angel of death” and suggested that babies were being killed at the unit. In January 2017, hospital management convened a meeting with the consultants. Dr. Jayaram described this meeting as becoming “very odd” when Chief Executive Tony Chambers instructed them to apologize to Letby and her family. According to Dr. Jayaram, Mr. Chambers “started relating to us how they have evidence from the grievance procedure we had treated Lucy Letby very badly and how she could have good grounds to report us to the General Medical Council for some of our behaviour.” He further stated, “We were told that she is coming back and we will have to work with her, and that some of you will have to undergo mediation.” Tony Chambers declared, “‘I’m drawing a line under it, you will draw a line under it and if you cross that line there will be consequences’.” Dr. Jayaram expressed, “We were all just absolutely blindsided by this.” Dr. Jayaram reported that Karen Rees, who was the head of nursing in urgent care, subsequently read a statement from Letby during the meeting. He recalled the statement as being “very assertive” and its tone “almost triumphant”. He commented, “It struck me that the meeting had probably been choreographed in some way.” Rachel Langdale KC, counsel to the inquiry, posed the question: “Did you know what you were supposed to be apologising for?” Dr. Jayaram responded: “No we didn’t, apart from our ‘bad behaviour’ but we didn’t know what that was.” He ultimately consented to signing a collective letter of apology from the consultants, despite the letter asserting that none of them had personally made any inappropriate comments. Dr. Jayaram stated that he communicated his “discomfort” regarding participating in a mediation session with Letby to Sue Hodkinson, who was then the trust’s HR director. He remarked: “I had no understanding how mediation worked. In retrospect it was an entirely inappropriate line to go down because mediation is when issues are resolved and it’s just for clearing the air so people can work with each other.” He indicated that “on balance,” he believed he should likely participate in the direct meeting with Letby and an independent mediator. Dr. Jayaram stated: “I was asked to read a statement to Letby. I wrote something along the lines of the apology.” He continued, “She told me that she had evidence from her grievance that myself and (fellow consultant) Dr Stephen Brearey had orchestrated a campaign to have her removed and that I and Dr Brearey had given an ultimatum to the trust that if she was not suspended we would call the police.” He added, “She said she was coming back next week whether I liked it or not and would I be happy working with her. It was a bizarre meeting.” Dr. Jayaram reported feeling “angry” upon exiting the meeting, believing that everyone, Letby included, “was being misled.” He refuted claims of either orchestrating a campaign to remove Letby from the unit or presenting any ultimatum to his superiors. Letby ultimately did not return to the neonatal unit, as hospital management contacted Cheshire Police in May 2017. Previously, Dr. Jayaram informed the inquiry, which is presided over by senior judge Lady Justice Thirlwall, that he regretted not having displayed “more courage” and expressed his worries about Letby after having to resuscitate a baby girl. Letby, aged 34 and from Hereford, is currently serving 15 whole-life orders. Her conviction at Manchester Crown Court was for the murder of seven infants and the attempted murder of seven others, including two attempts on one victim, occurring between June 2015 and June 2016. The inquiry, convening at Liverpool Town Hall, is anticipated to continue until early 2025, with its conclusions slated for publication by late autumn of the same year. Reporting also contributed by PA Media. For further content, listeners can access BBC Radio Merseyside on Sounds and follow BBC Merseyside on Facebook, X, and Instagram. Story suggestions can be sent to northwest.newsonline@bbc.co.uk or via Whatsapp to 0808 100 2230. Copyright 2024 BBC. All rights reserved. The BBC bears no responsibility for the content found on external websites. Information regarding their external linking policy is available.