
The Thirlwall Inquiry into the Lucy Letby case will not reassess her convictions but will examine hospital management failures, with the CCRC and Cheshire Police monitoring its findings for potential impact on ongoing legal proceedings and public debate.
AI-generated summary
Lucy Letby was convicted of murdering seven babies and attempting to murder seven more, with two juries finding her guilty and appeals denied. The Thirlwall Inquiry was established to examine hospital management failures during the neonatal unit crisis, not to reassess her convictions.
Mention Lucy Letby and you're likely to get a strong reaction.
The nurse was sentenced to spend the rest of her life in prison for murdering seven babies and attempting to murder seven more.
But though two juries have convicted her, and she has twice been denied permission to appeal, it seems everyone has an opinion on whether she really did it.
There's loud scepticism about her convictions from some, and vocal certainty about her guilt from others. She has become the centre of an information war.
The name Lady Justice Thirlwall, however, attracts less recognition.
The quick take is this. The report won't change the narrative about Letby's guilt or innocence because it didn't examine that subject at all. That wasn't its remit.
Lady Justice Thirlwall said she had "approached the inquiry on the basis that Lucy Letby is guilty of the crimes of which she has been convicted".
She emphasised that it was not her role "to set about reviewing the convictions", telling the inquiry: "The Court of Appeal has done that, with a very clear result."
But there is also a longer, more complex answer.
Whatever the report's conclusions, Letby's convictions will stand. However, the inquiry hasn't operated in a vacuum. There are other parts of the legal system which will have an eye on its findings.
And the chairwoman of the Criminal Cases Review Commission (CCRC) - the only organisation with the power to send Letby's case back to the Court of Appeal - has told the BBC the CCRC will be paying close attention to Thirlwall.
Dame Vera Baird said: "We will be looking at the report with interest to assess whether it has any bearing on our review of the case."
The CCRC has given no indication of when it will make its decision.
But while questions over Letby's convictions weren't within the scope of the Thirlwall Inquiry, it didn't stop the subject making itself felt within the hearing room.
Just as the inquiry was wrapping up, the hospital's former executives applied for it to be delayed until the CCRC has made its decision.
Letters pushing for a delay were also written to the inquiry by Letby's lawyers and Sir David Davis, an MP who has campaigned on her behalf.
Sir David argued that an inquiry "predicated on the presumption that Lucy Letby's conviction is safe, when there is now a wealth of authoritative voices questioning that conviction, will only undermine the conclusions arrived at by your inquiry and potentially lead to more babies dying unnecessarily".
Lady Justice Thirlwall refused the requests to pause the inquiry. She said that she was not scrutinising Letby's actions, but those of the officials and managers who were responsible for responding to the crisis.
The most stark question it may answer is whether any babies might have lived, or avoided injury, if action had been taken earlier.
The inquiry released thousands of documents which shed new light on what was going on inside the hospital. When the hearings finished, we put together this timeline which illustrates how events unfolded.
Should alarm bells have started ringing as early as June 2015 when three babies died in quick succession – the same number of deaths within two weeks that the unit would normally expect in a year? What about in August 2015, when a baby was poisoned with insulin?
The results of his blood test didn't raise an alert. At the inquiry, hospital consultants accepted this had been a "collective failure".
Lawyers for the baby's family said the test results "provided the clearest opportunity to detect and stop Letby" and were "a bright line within the chronology after which no babies should have been harmed".
By early 2016, senior managers including medical director Ian Harvey and director of nursing Alison Kelly knew there was an unusually high death rate on the neonatal unit and that there were escalating concerns about a nurse. But it didn't lead to safeguarding action.
It was only after two triplet brothers died in June 2016 that Letby was taken off nursing duty.
Thirlwall will also make recommendations for change. These could include new controls on the storage of insulin; compulsory procedures to be followed when deliberate harm is suspected; detail on the regulation of NHS managers and executives; and greater use of CCTV within neonatal units.
She will also expose the number of recommendations made by public inquiries into more than 30 previous NHS scandals, which have not been followed.
Analysis by the inquiry's legal team showed that, of more than 1,400 recommendations made by previous healthcare-related inquiries, the majority have not been clearly implemented.
Solicitor Richard Scorer refers to the failure to implement recommendations from public inquiries as "the British disease".
"It is a betrayal not just of the people who have suffered in these cases, families like those I represent, it's actually betrayal of the public," he said.
Journalist David James Smith, who is a former CCRC Commissioner, says the commission will be paying attention to the Thirlwall report "for any evidence that supports or undermines the convictions and supports or undermines the submissions it has received on Letby's behalf".
Cheshire Police will also have a close eye on the Thirlwall report. A criminal investigation into three hospital executives is still underway. They were previously arrested on suspicion of gross negligence manslaughter, and one of them has since been rearrested on suspicion of perverting the course of justice.
It's likely that detectives will look closely at the inquiry's findings about those managers, which could be factored into their investigation.
And then there is the public debate.
As the legal wheels have been turning in the background, those campaigning to free Letby have redoubled their efforts, with protests and websites dedicated to her cause. But there are also strong feelings from those who believe she belongs in jail. Both sides have found energy online, within highly active forums on Facebook, Reddit, Tattle Life, and elsewhere.
How will Lady Justice Thirlwall's report go down with those communities?
David Wilson, emeritus professor of criminology at Birmingham City University, believes it's unlikely that the report will reverse hard-baked opinions.
"The 'noisier' Letby commentators are almost universally on the side that she is innocent," he says. "I have no doubt there will be aspects of the governance of the hospital where she killed within the report that will be harnessed to support that view."
Prof Wilson believes it will become "another component of the information war that's constantly being waged about her guilt or innocence" and he feels much of the conversation about Letby "seems to generate more heat than light".
One thing is certain. No matter what their point of view, everyone with a strong opinion about Letby will pay close attention to the report. Even those who wanted it to be delayed, or who didn't support it in the first place, will scour its findings.
But it's much less likely to take the heat out of the public debate or draw a line under the case. Those who say they're already sure about Lucy Letby may scrutinise the report, but take from it whatever supports those ready-formed views.
AI outlook — possibilities, not facts
The CCRC will review the Thirlwall report to determine if it has any bearing on Lucy Letby's case
Very likely · Within months
Cheshire Police will examine the Thirlwall report's findings about hospital executives for their ongoing investigation
Very likely · Within months
The Thirlwall report will not change public opinion on Lucy Letby's guilt or innocence
Likely · Within weeks

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