A group of scientists and medical professionals has called for the postponement of the Thirlwall Inquiry, set to examine the circumstances surrounding baby deaths at the Countess of Chester Hospital. This request comes in the wake of Lucy Letby's conviction for the murder of seven infants and attempted murder of six others.
In a letter addressed to Wes Streeting, Shabana Mahmood, and Lady Justice Thirlwall, two dozen experts, including members of the Royal Statistical Society (RSS), university professors, and NHS staff, have expressed concerns about the inquiry's current scope. They argue that a delay is necessary to allow for a more comprehensive investigation and to address wider professional concerns.
The signatories, which include Peter Elston, a fellow of the RSS, and Prof Peter Green, a former RSS president, emphasize the need to examine multiple potential causes of neonatal deaths at the hospital. They believe that adjusting the inquiry's scope is crucial for a thorough understanding of the events and their implications for the NHS as a whole.
The experts highlight the vulnerability of legal systems when dealing with complex scientific evidence, particularly in cases involving statistical anomalies in healthcare settings and the intricate physiology of newborns. They stress that their goal is not to relitigate the Letby case but to address systemic issues in neonatal care and hospital management to improve patient safety across the healthcare system.
Historical staffing issues at the Countess of Chester Hospital have come to light. In 2004, nurses wrote to the NHS trust expressing "grave concerns" about understaffing in the neonatal unit, which was 30-40% below guideline levels. By 2011, eight registered nurses had left the unit, replaced by unregulated nursery nurses. In 2015, staff reportedly were in tears due to being forced to care for more babies than they could safely manage.
"Between 2015 and 2016, there were organisational and environmental issues with the ward and major issues with understaffing... [There was a] pattern of insufficient senior cover and a reluctance to seek advice from consultants."
The RCPCH investigation, which was not presented to the jury during Letby's trial, revealed serious concerns about the unit. It highlighted insufficient senior cover, reluctance to seek advice from consultants, and nurse staffing levels frequently below recommended standards. The review team emphasized the need for greater senior doctor availability, given the vulnerable nature of premature babies in the ward.
Environmental factors also played a role, with the hospital struggling to eliminate dangerous bacteria in the neonatal unit's taps and issues with raw sewage entering the ward due to poor plumbing. These problems coincided with the period of increased deaths.
Despite these concerns, the government has stated that the inquiry's terms were set following 'wide-ranging engagement'. A spokesperson for the inquiry confirmed that the hearings would adhere to the terms of reference established by Shabana Mahmood.
As the debate continues, the call for a broader investigation highlights the complex interplay of factors that may contribute to patient safety in neonatal care settings. The outcome of this request could have significant implications for how the NHS addresses systemic issues and improves care for its most vulnerable patients.