Hospital Director Testifies to Feeling “Out of Depth” Regarding Letby Concerns

Karen Townsend, the divisional director of urgent care at the Countess of Chester Hospital, stated that she felt “out of her depth” while addressing concerns raised by doctors regarding the serial killer nurse Lucy Letby. Her testimony was given at the public inquiry into Letby’s offenses, held at Liverpool Town Hall. During the inquiry, Ms Townsend faced questions regarding her perceived lack of decisive action after senior medical professionals informed her of their apprehension that Letby was connected to a rise in unforeseen deaths and collapses within the neonatal unit. She explained to the inquiry that she lacked “clinical insight” into the circumstances and was guided by how the “executive team wanted to manage it”. The Thirlwall Inquiry was informed that Ms Townsend first learned of these concerns during a meeting with consultant Dr Ravi Jayaram on 24 June 2016, which occurred at a coffee shop within the hospital. This meeting transpired following the death of a triplet identified as Baby O, a murder for which Letby was subsequently convicted, but prior to Letby’s killing of the second triplet, known as Baby P. Subsequently, the prospect of involving the police was deliberated at a separate meeting with senior managers on 30 June 2016; however, the inquiry learned that this action was not taken until 2017. When questioned whether she believed the police should have been contacted by the close of June that year, Ms Townsend responded: “I probably felt out of my depth because I didn’t have the clinical insight, I didn’t have the clinical knowledge and this was a very, very serious situation and I felt I was very much being led by how the executive team wanted to manage it at that time because of how awful a scenario it was.” She was further questioned regarding her decision not to record the concerns voiced by Dr Jayaram – which he indicated were also held by his colleague Dr Stephen Brearey – on the hospital’s risk register following their discussion. Ms Townsend informed the inquiry that “no details” were provided during the “ad-hoc” meeting, stating: “It was a very vague reference, there was no evidence to substantiate [ the concerns].” Ms Townsend stated that she did consult Karen Rees, who was the head of nursing in urgent care at that period. When asked why she did not promptly notify the hospital’s executive team, Ms Townsend replied: “That was kind of my naivety in my role but also [Drs Jayaram and Brearey] had those concerns and obviously they had far more detail than I.” She also raised the question of why the doctors themselves had not approached the executive team. Richard Baker KC, a barrister representing some of the families of Letby’s victims, highlighted that the meeting between Ms Townsend and Dr Jayaram coincided with the period when Letby was assaulting Baby P. He then inquired: “On reflection do you think it required urgent action from you to remove Lucy Letby [from the neonatal unit] ?” Ms Townsend responded: “So all of what you’ve articulated I did not know. “I had no sight, nor did I hear anything. The conversation I had with Dr Jayaram was very brief. “He and Dr Brearey and some of his colleagues had some concerns. “We didn’t go into any detail and there was certainly no specifics that you’ve just articulated.”” Mr Baker then questioned what level of detail she would have required before acting, had a doctor expressed concern about a nurse attacking infants. She stated: “The terms ‘attacking’ and ‘harming’ weren’t used at all.” Subsequently, Ruth Millward, a patient safety manager, testified to the inquiry, highlighting an unhealthy practice within the NHS where individuals are copied into emails, allowing them to claim information