Letby told consultant 'she would come back' to unit

Former neonatal nurse Lucy Letby is serving 15 whole life sentences

Lucy Letby told a consultant paediatrician she was coming back to the Countess of Chester Hospital’s neonatal unit "whether you liked it or not", a public inquiry has heard.

Dr Ravi Jayaram said Letby made the comment in a "bizarre" meeting in late March 2017, just days before he understood NHS bosses had planned her return to the unit under supervision.

Letby had been redeployed to clerical duties in July 2016 after all seven consultants in the unit warned executives she may be deliberately harming babies after a series of sudden and unexplained deaths and collapses.

"She said she was coming back next week whether I liked it or not and would I be happy working with her," Dr Jayaram told the inquiry.

The inquiry heard Letby had launched a grievance procedure against her transfer from the neonatal unit.

Junior doctors had allegedly made reference to an unnamed nurse being an "angel of death" and that babies were being killed there.

In January 2017 hospital bosses called consultants to a meeting, which Dr Jayaram said became "very odd" when chief executive Tony Chambers told them they had to apologise to Letby and her family.

Dr Jayaram said Mr Chambers "started relating to us how they have evidence from the grievance procedure we had treated Lucy Letby very badly and how she could have good grounds to report us to the General Medical Council for some of our behaviour.

"We were told that she is coming back and we will have to work with her, and that some of you will have to undergo mediation.

"Tony Chambers said ‘I’m drawing a line under it, you will draw a line under it and if you cross that line there will be consequences’.

"We were all just absolutely blindsided by this."

'Choreographed'

Dr Jayaram said Karen Rees, head of nursing in urgent care, then read out a statement from Letby at the meeting.

He said he remembered it being "very assertive" and its tone "almost triumphant".

"It struck me that the meeting had probably been choreographed in some way," he said.

Counsel to the inquiry Rachel Langdale KC asked: "Did you know what you were supposed to be apologising for?"

Dr Jayaram replied: "No we didn’t, apart from our ‘bad behaviour’ but we didn’t know what that was."

He said he eventually agreed to sign a joint letter of apology from the consultants, although it stated none of them had made any inappropriate comments themselves.

Dr Jayaram said he spoke to the trust's then HR director Sue Hodkinson about his "discomfort" about taking part in a mediation session with Letby.

He said: "I had no understanding how mediation worked. In retrospect it was an entirely inappropriate line to go down because mediation is when issues are resolved and it’s just for clearing the air so people can work with each other."

'Angry'

He said that "on balance" he felt he probably ought to engage in the face-to-face meeting with Letby and an independent mediator.

Dr Jayaram said: "I was asked to read a statement to Letby. I wrote something along the lines of the apology.

"She told me that she had evidence from her grievance that myself and (fellow consultant) Dr Stephen Brearey had orchestrated a campaign to have her removed and that I and Dr Brearey had given an ultimatum to the trust that if she was not suspended we would call the police.

"She said she was coming back next week whether I liked it or not and would I be happy working with her. It was a bizarre meeting."

Dr Jayaram said he was "angry" when he left the meeting because he thought everyone, including Letby, "was being misled".

He denied either staging a campaign to move Letby out of the unit or issuing any ultimatum to his bosses.

Letby never returned to the neonatal unit as hospital bosses eventually called in Cheshire Police in May 2017.

Earlier, Dr Jayaram told the inquiry, chaired by senior judge Lady Justice Thirlwall, that he wished he had shown "more courage" and voiced his concerns about Letby after he had to resuscitate a baby girl.

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, sitting at Liverpool Town Hall, is expected to sit until early 2025, with findings published by late autumn of that year.

Additional reporting by PA Media