Lucy Letby trial: Staffing levels were unsafe, nurse tells jury

Lucy Letby has denied murdering and attempting to murder babies at the Countess of Chester Hospital

Nurse Lucy Letby believed staffing levels on a hospital's neonatal unit were "completely unsafe", her murder trial has heard.

Ms Letby was in the witness box at Manchester Crown Court earlier to give her third day of evidence.

She is on trial accused of the murders of seven babies and the attempted murders of 10 others at the Countess of Chester Hospital between June 2015 and June 2016.

Ms Letby, 33, denies all charges.

Her barrister, Ben Myers KC, asked Ms Letby, originally of Hereford, for her memory of the neonatal unit in September 2015.

In the months prior, the hospital had seen the deaths of four babies and collapses of four others.

She told the court at that time the unit was at "overcapacity" as it catered for 16 babies, but had 18 babies staying.

She said "it was increasingly busy at this period" and she had not seen it as "busy as this".

In a message to a colleague, sent at that time, the defendant said staffing was "completely unsafe".

Neonatal nurse Lucy Letby worked at the Countess of Chester Hospital

Ms Letby explained in late September the unit was caring for a baby girl, Child H, who required three chest drains.

She said she had never seen a baby with three chest drains, even at a tertiary centre.

"The most I had seen was two," she said.

The accused said at that time she was unhappy caring for Child H "due to a lack of appropriate support".

"I wanted support from a senior member of staff," she said.

Mr Myers highlighted a message, previously shown to the jury, from the then neonatal unit manager Yvonne Griffiths to Ms Letby in September 2015.

Ms Griffiths said: "I just want to commend you for all you hard work these last few nights.

"You composed yourself very well during a stressful situation. It's nice to see your confidence grow as you advance through your career x."

Lucy Letby wiped away tears as she gave evidence for the first time in the witness box on 2 May

Earlier Ms Letby denied attempting to murder another infant, referred to as Child F, by injecting insulin into his nutrition during a night shift.

The court previously heard how the baby boy's heart rate soared and his blood sugar dropped to a dangerously low level after the prescribed bag was connected to an intravenous line after midnight on 5 August 2015.

His blood sugar levels remained low throughout the following day shift even after the intravenous long line, and the connected bag, had to be replaced after swelling to the infant's leg.

Mr Myers asked the nurse if there was "anything you did or know of that accounts for [Child F's] drop in blood sugar".

She responded: "No".

Social media searches

Asked if she knew why Child F's blood sugar levels continued to remain low on the day of 5 August, she answered "no".

Mr Myers went on to ask Ms Letby why she searched for the mother of Child F nine times on Facebook between August 2015 and January 2016, and the father on one occasion.

She said searching for people on social media was "a normal pattern of behaviour for me" and was not confined to the parents of children in this case.

Mr Myers also asked about Child G, who was born in May 2015, and was the most premature of all the babies in this case.

The court has heard that in mid-August, she was transferred from Wirral's Arrowe Park Hospital and was "clinically stable" until 7 September, when she projectile vomited at about 02:00 BST.

Lucy Letby, 33, denies all of the charges against her

Prosecutors allege Ms Letby overfed Child G with milk through a nasogastric tube or injected air into the same tube and made two more attempts to kill her on 21 September.

Asked if she recalled Child G, Ms Letby said: "She stood out as a baby who had complex needs, and was a very premature baby."

She told jurors she would have cared for Child G "many times" during her stay at the Countess of Chester Hospital.

Asked about the events of 7 September, the defendant said she was at the nurses' station, opposite nursery two, with colleague Ailsa Simpson.

She said: "Myself and Ailsa were sat at the nursing station, we had been there for a few minutes at least and then we heard [Child G's] monitor alarm in nursery two and heard quite a loud retching noise.

"We both immediately went in there and found [Child G] vomiting and struggling to breathe."

Ms Letby said she did not have "any particular contact" with Child G on that shift prior to the vomiting incident.

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On 21 September 2015, the prosecution say Ms Letby switched off Child G's oxygen monitor and caused her to collapse.

The nurse refuted this and said on her shift she found Child G alone, on a procedure trolley and disconnected from her monitor.

She said Child G should "never" have been left in that way and that it was "not good practice at all".

She told the court she raised her concerns with senior nurses and wanted to submit an incident report.

The court has previously heard, from a nursing colleague who cannot be named, that consultant Dr John Gibbs had apologised for leaving the child this way after a cannulation procedure.

The trial continues.