As the Thirwall hearings approach, the Guardian has discovered concerns were repeatedly raised about alarming shortcomings at Countess of Chester
At Liverpool town hall on Tuesday, a public inquiry will begin into the tragic deaths and collapses of babies eight years ago at the Countess of Chester hospital for which the former neonatal nurseOne of the inquiry’s principal aims is to give the babies’ bereaved families a sense that lessons will be learned.
The inquiry will begin its hearings in this highly unusual context: its very premise – that a murderer was at work – being the subject of dispute.that 24 senior experts had written to the government urging it to either pause the inquiry or expand its remit. The letter said the narrow terms of reference could lead to “a failure in understanding and examining alternative, potentially complex causes for the deaths”.
Our investigation reveals a hospital unit operating beyond its skills and capacity – one that was understaffed and suffering from low morale, lacking the expertise to deal with babies with serious needs, and operating from a tired building struggling with a superbug and with sewage backing up into its rooms., in north-west England. In 2015, when the hospital started to experience a rise in the number of deaths of premature babies, its neonatal facility was classed as a level-two local unit.
But during the period of the cluster of deaths, there were staff at the hospital, including managers and members of the nursing team, who rejected the suggestion that Letby was responsible, and raised possible alternative causes for the increase in deaths, including medical explanations. A further entry in late October 2015 recorded a specific troubling evening, four nights after another baby had died. There had been no senior doctor present overnight, Powell wrote, only a middle-grade doctor and a junior doctor still in training. Between them they were trying to cover five separate areas where babies and children might get into difficulty: the paediatric ward, the neonatal unit, the labour ward, casualty, and the ante and postnatal ward.
Dr Jane Hawdon, a consultant neonatologist at the Royal Free hospital in London, was asked by the CoC to review 17 cases in which babies had collapsed or died in more detail and individually. The conclusions of her report, seen by the Guardian, were that the deaths or collapses of 13 babies could be explained, and “may have been prevented with different care”.
Letby had been removed from the unit, coinciding with the downgrading to a lower level. The number of deaths fell thereafter.Another major concern at the time, both at the CoC and nationally, was the shortage of nurses. The neonatal unit was operating with the number of nurses a fifth lower than required by national standards. It should have had one nurse to each baby in its intensive care room, a ratio that was frequently breached.
Powell, the nurse manager, had recorded a lack of available transport as a high risk to babies on the hospital register in March 2016, highlighted in red under the register’s traffic light system.
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