Lucy Letby consistently alerted officials about inadequate care for infants at the hospital where she was employed, according to documents acquired by The Mail on Sunday.

The case of the former nurse, found guilty of killing seven newborns and attempting to murder seven more at the Countess of Chester Hospital, is under heavy scrutiny. This follows experts questioning critical aspects of the prosecution’s arguments.

At 35, Letby was found guilty largely based on debated statistical analyses and controversial theories regarding her potential methods of harming the infants. The verdicts were reached without concrete forensic or surveillance evidence or an established motive.

Now, hospital management records show she officially reported suspected care failings in the neonatal unit just before she was removed from her position at the behest of a senior doctor. Subsequently, the police were contacted to determine if the infant deaths were intentional acts of murder.

Last night, the head lawyer of Letby’s new defense team argued that she became a target for senior doctors seeking revenge for her whistleblowing. An international expert panel recently suggested that the infant deaths were due to substandard care or natural causes rather than murder.

The documents – called Datix Admin and Management Forms – cover a number of medical emergencies in the unit in 2015 and 2016.

The team that reviewed Letby’s concerns included Dr. Stephen Brearey, one of the two doctors who later raised speculation about her possibly ‘deliberately harming babies.’

On June 30, 2016 Letby used the system to report an incident a week earlier when a baby had suffered a ‘sudden acute collapse requiring resuscitation’, only for staff dealing with the emergency to find that the sodium bicarbonate infusion required to deal with the crisis was not available.

Dr Brearey’s investigating group recommended new measures to ‘ensure adequate stock levels in future’. Letby filed a second report about another baby on the ward who had collapsed three hours after the first incident, saying that ‘resources were not available on Unit’ to deal with the emergency.

Dr Brearey later amended her incident form to state that the medical resources mentioned were not necessary to deal with the incident and in any case were not ‘routinely kept on the unit’ – but then conceded that due to ‘a recent increase in usage’ delivery would be arranged.

Another report by Letby in June 2016 identified failures by doctors over the administration of intravenous medication. Dr Brearey’s group concluded that nurses should check the equipment ‘on an hourly basis’ and that Dr Brearey would ‘update new doctors at induction’.

At Dr Brearey’s request, Letby was transferred from clinical duties the following month. She was arrested in 2018. Other reports by Letby included the ‘unexpected death’ of a baby in August 2015 which concluded that ‘neonatal care was appropriate… it is unlikely any changes in management would have prevented this sad outcome’; the deterioration of an infant after ventilation records were not recorded for a 12-hour period; and a ‘chest drain complication’ due to a lack of needles on the ward. 

The revelations come after two television documentaries broadcast this month highlighted mounting questions about the safety of Letby’s convictions.

Dr Neena Modi, ex-president of the Royal College of Paediatrics and Child Health, told ITV’s Lucy Letby: Beyond Reasonable Doubt?: ‘It’s been deeply disturbing that one can have such a… tremendously important trial that seems to have been conducted with so many flaws.’

BBC’s Panorama featured expert Dr Mike Hall, who warned that flaws in the evidence produced by Letby’s new defence team could undermine her chance of a fair retrial.

Dr Hall, who prepared reports for Letby’s first trial in 2022 and sat through ten months of hearings, was baffled not to be called by her original team to contest the prosecution’s evidence.

He told the BBC: ‘In terms of natural justice, I don’t think she should have been found guilty… there is no evidence of inflicted injury in the babies.’

Letby’s lawyer, Mark McDonald, who has submitted an application to the Criminal Cases Review Commission, said: ‘Lucy was a hard working, experienced nurse who loved her job and would never harm any child which is why she would not let any fault pass. This was a neonatal unit in crisis and she consistently formally reported issues.

‘She was a whistleblower – but instead of listening to her they went for her instead.’

An official inquiry led by Lady Justice Thirlwall has been launched into events at the hospital and will examine: the conduct of all junior and senior staff; the experiences of bereaved parents and the effectiveness of NHS management and structures.

Lady Thirlwall has stressed she will not be ‘scrutinising’ Letby but ‘the actions of all those who were in the hospital’. She will publish her report early next year.

A spokesman at the Countess of Chester Hospital NHS Foundation Trust said: ‘Due to the Thirlwall Inquiry and the ongoing police investigations, it would not be appropriate to comment further at this time.’