Lucy Letby initially failed her student nurse placement after ‘lack of empathy’

Lucy Letby initially failed her final year placement as a student nurse after her perceived lack of empathy with patients and families, a public inquiry has revealed.

Letby’s assessor, Nicola Lightfoot, deputy ward manager at the Countess of Chester Hospital’s children’s unit, told the inquiry it was apparent to her that Letby, who was later convicted of multiple infant murders, did not have the “overall characteristics” to become a successful registered nurse.

She testified at the Thirlwall Inquiry that Letby lacked the essential qualities of a successful registered nurse. “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,” she said.

Ms Lightfoot noted that while some students excel academically, they may struggle with the interpersonal skills necessary for pediatric care, including empathy, kindness, and the ability to build relationships with families.

She also highlighted Letby’s inadequate clinical knowledge, citing her difficulties with medication dosages and recognising drug side effects.

In her July 2011 report, Lightfoot 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, she expressed hope that with continued effort, Letby could improve.

Students who failed their final placements were allowed to retake them. Letby passed her remaining competencies during a four-week placement under a different supervisor, which she requested after feeling “intimidated” by Ms Lightfoot.

Ms Lightfoot was unsurprised by this, acknowledging her role in rigorously challenging students.

“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,” she said.

Sarah Jane Murphy, Letby’s next mentor, described Lightfoot as a highly experienced nurse who would not fail a student without justification. Ms Murphy admitted to feeling conflicted about passing Letby, despite positive feedback from other staff members.

Ms Murphy, who also mentored Letby during her first year, recalled her as quiet and shy, lacking interpersonal skills with children, parents, and colleagues. She attributed this to Letby’s youth and inexperience, noting her tendency to linger around the nurses’ station with an expressionless demeanour.

At the end of Letby’s first placement, Ms Murphy advised her to improve her communication skills, especially with children and their families.

Lightfoot recounted an unsettling incident following the deaths of two triplet boys in June 2016. She overheard Letby make an “inappropriate” comment, which she described as sounding excited about the tragic events. “It wasn’t an appropriate response to the death of a child,” Ms Lightfoot said, noting that she had never witnessed such a reaction from a nurse involved in a patient’s death.

Letby, now 34, is serving 15 whole-life orders after being convicted of murdering seven infants and attempting to murder seven others between June 2015 and June 2016.

The Thirlwall Inquiry is set to continue at Liverpool Town Hall until early next year, with findings expected to be published by late autumn 2025.