‘Cold’ Letby initially failed final year student nurse placement, probe told
An assessor at the Countess of Chester Hospital said it was apparent that Letby lacked empathy with patients.
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Your support makes all the difference.Lucy Letby initially failed her final year placement as a student nurse after she was noted to be “cold” and lacking empathy with patients and families, a public inquiry has heard.
Her assessor Nicola Lightfoot, deputy ward manager on the children’s unit at the Countess of Chester Hospital, said it was apparent to her that Letby did not have the “overall characteristics” to become a successful registered nurse.
Giving evidence at the Thirlwall Inquiry into events surrounding the neonatal nurse’s crimes, Ms Lightfoot said: “I found Lucy to be quite cold. I did not find a natural warmth exuding from her which I expect from a children’s nurse.
“We see students that are extremely academic, but actually from a personality point of view they don’t seem to blend into the role of being a children’s nurse which includes characteristics (such) as empathy, being kind, being friendly and being able to establish good relationships with our families.”
Ms Lightfoot also found that Letby’s clinical knowledge was “not where it should be” and that she “struggled” to retain information over calculating dosages of drug medication and also to recognise side effects of common drugs.
I have to be sure that this person is ready and safe to practice and I wasn't prepared to put my professional reputation and registration on the line at that point
In her final report on the then University of Chester student in July 2011 she wrote: “At the moment Lucy requires much more support, prompting and supervision than I would expect at this stage to allow her to qualify as a competent practitioner.
“However I strongly feel if Lucy continues to take on board feedback, continues to work on her weaker areas and develop her practice accordingly then this is achievable in the future.”
Any student who failed their final placement had the opportunity to repeat it and achieve the competencies they had not achieved, the inquiry heard.
Letby passed her three outstanding competencies in a four-week retrieval placement which started the next day with a different supervisor which she had requested after she said she felt “intimidated” by Ms Lightfoot.
Ms Lightfoot said that she was not surprised by this comment as it was her role to challenge students about their knowledge and skills.
She said: “I felt I couldn’t objectively continue as Lucy’s mentor, and she felt the same, because I genuinely did not think in four weeks she would be at a level to sign her off.
“I have to be sure that this person is ready and safe to practice and I wasn’t prepared to put my professional reputation and registration on the line at that point.”
Her next mentor, Sarah Jayne Murphy, stated to the inquiry that she thought Ms Lightfoot was a very experienced nurse who would never have failed a student without good reason.
She added she was “conflicted” over later passing Letby but said she had met the standards required and had received positive feedback from other members of staff.
Ms Murphy also mentored Letby in her first year as a student nurse, the inquiry was told.
She recalled: “I remember Letby being quiet and I thought shy.
“She didn’t show good inter-personal skills with children, parents, nurses or the wider team. I believed this to be Letby’s lack of confidence and experience as she was very young and an only child away from home.
“There was a tendency upon some students to hang around the nurses’ station and the desk area. Letby was one of these students and often had quite an expressionless look which I and other staff members found awkward.
“I think she felt comfortable working with me but she remained quiet and never appeared particularly animated or to be enjoying herself.
“At the end of the first placement I remember telling Letby although she had passed the placement it was important that she develop her communication skills, especially with the children and the families.”
Ms Lightfoot also told the hearing she overheard an “inappropriate” comment from Letby in the wake of the deaths of two triplet boys on successive days in June 2016 – who Letby was later convicted of murdering.
She said: “As I was coming out of the break room I passed Lucy, who didn’t see me. She was coming out of her unit and greeting a member of the night staff that was coming on and I heard her say something along the lines of: ‘You’ll never guess what’s happened.’ The way she said it seemed like she was talking about some sort of exciting event she had witnessed.
“It wasn’t an appropriate response to the death of a child. I have never, and I have never since, seen a response like that to a nurse involved in a patient’s passing.”
Nurse Ailsa Simpson stated to the inquiry: “After the death of the third or fourth baby, it was generally noted that she (Letby) was involved in each case. This was the only point that the NNU (neo-natal unit) staff observed.
“At that point I did not consider she was the cause of the issues and I thought her involvement might just have been a coincidence.”
Her colleague Vicky Blamire said: “It wasn’t until finding out about more and more fatalities that questions were asked about which members of staff were present at the time as this would have had a big impact on their mental health.
“Hearing Lucy’s name with every occasion made me feel very uncomfortable as she didn’t show any kind of emotion.
“I remember feeling very shocked and confused as to why she didn’t seem to be upset. This was very unnerving.”
Another nurse, Janet Cox, said she had no concerns or suspicions about Letby’s conduct and believed she was an “exemplary nurse who was completely innocent of all the alleged crimes”.
She stated: “Obviously any death is a worry but I did not think this at the time, nor do I think now that there was anything sinister about the increase in the number of deaths/collapses.
“I do not see how you can set a figure on how many deaths are acceptable in one particular timeframe. The very reason these babies required admission to an NNU was because they had a high chance of dying or collapsing.”
Letby, 34, from Hereford, is serving 15 whole-life orders after she was convicted at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims, between June 2015 and June 2016.
The inquiry is expected to sit at Liverpool Town Hall until early next year, with findings published by late autumn 2025.