‘We should have acted faster on Letby’, nursing watchdog chief admits

Paul Rees, who was appointed head of the Nursing and Midwifery Council (NMC) in July, said the regulator should have suspended the child killer when she was first arrested.

Letby, currently in prison serving 15 life terms, remained free to work without any NMC-imposed restrictions until she was charged in November 2020.

Mr Rees admitted the regulator, which is responsible for overseeing nearly 800,000 nurses, midwives and nursing associates, had got its handling of sexual misconduct cases “completely wrong” in the past.

He noted that refusal to investigate nurses who had been accused of committing sexual assault outside of work had been a problem .

"We have to be honest about things that have gone wrong. And things have gone wrong in the past," said Mr Rees.

The new chief also apologised for the regulator not acting faster to suspend a psychiatric nurse who was later jailed for rape and voyeurism, with John Iwuh was permitted to work with patients for a year after police first told the NMC of their investigation.

Mr Rees said the organisation should've moved faster to both investigate and to look for an interim order, as well as to communicate with employers.

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According to reports, the NMC has not investigated nurses accused of abuse, sexual assault and domestic violence occurring outside the workplace, as it did not consider this to be in its remit.

“The issue was that the guidance stated where nursing and midwifery or professionals did something outside of their working life, it was outside of our concerns – that was completely wrong.

“It should’ve been saying what you do outside of work is just as important as what you do at work.”

Lady Thirwall’s final report on the public inquiry into authorities’ handling of the Letby case is due next year.

Asked if he expects it to criticise the regulator, Mr Rees said he wasn't sure, but "it’s a possibility because we should’ve acted faster with Lucy Letby".

"We’ve changed the guidance, so it is clear now where there is an exceptional case of serious criminal wrongdoing, we take action and implement an interim order." he said.

"It’s incumbent upon us to move fast and bring about these interim orders.”

The NMC was contacted by the Countess of Chester Hospital’s then-director of nursing Alison Kelly in July 2016.

Concern was highlighted after consultant paediatricians raised fears to executives that Letby may be deliberately harming babies on the neonatal unit. As consequence, she was redeployed to non-clinical duties.

Letby was due to return to the neonatal unit, but the move was put on hold after hospital chiefs contacted Cheshire Constabulary in May 2017 to ask them to investigate the increased number of deaths.

She continued to work in the Countess of Chester’s risk and patient safety department until her arrest in July 2018.

After her arrest, a senior lawyer at the NMC concluded there was insufficient grounds to obtain an interim order – which could have led to a suspension or restriction of practice – without her being charged.

Once convicted, Letby was stripped of her nursing credentials and struck off the register at an NMC fitness to practise hearing in December 2023.

Letby, 35, was given 14 whole life orders in August 2023 after being found guilty at Manchester Crown Court of the seven murders and six attempted murders.

She was given a further whole life order in July 2024 after being convicted of attempting to murder another baby.