Posted by 
Lucy Letby was convicted in two trials in 2023 and 2024 of murdering seven babies and attempting to murder six others in her care at the Countess of Chester hospital in north-west England between 2015 and 2016.
She is currently serving 15 whole life sentences for the murders. But the case has been called into question as a result of growing concerns about the expert evidence presented at her trial. Will she get a retrial? Here’s what happens next.
In the context of usually cautious expert opinion, the press conference held on February 4 2025 was extraordinary. An international panel of medical experts investigating the medical evidence against Lucy Letby concluded that there were alternative explanations for each of the deaths. They said they found no evidence of deliberate harm, and believe Letby did not murder any babies.
The panel’s chair, Dr Shoo Lee, is a retired neonatal care expert. His 1989 paper on air embolisms was heavily relied on by the prosecution in the Letby trial and appeals. However, Lee has previously said that his research was misinterpreted at trial. At the press conference he said, “we did not find any murders. In all cases, death or injury were due to natural causes or just bad medical care.”
Want more politics coverage from academic experts? Every week, we bring you informed analysis of developments in government and fact check the claims being made.
Sign up for our weekly politics newsletter, delivered every Friday.
The panel’s findings put the case in uncharted territory, given Letby’s very recent convictions and the continuing public inquiry into the case.
The public inquiry – the Thirlwall Inquiry into events at the Countess of Chester hospital – will operate based on the assumption, following her convictions, that Letby is guilty. Letby’s barrister has called for the inquiry to be halted pending the Criminal Cases Review Commission (CCRC) review of her case.
Despite the findings of the expert panel, Letby’s release or even a retrial is by no means imminent, let alone guaranteed. Letby has already had two applications for leave to appeal refused. The grounds of appeal were related to what her defence argued were errors in judicial decision making during the trial, rather than the medical evidence. Nonetheless, this means that the CCRC is the only route left open to Letby to challenge her convictions.
Letby’s defence team confirmed that a preliminary application has been made to the CCRC, with a full submission to follow. The CCRC investigates potential miscarriages of justice in England, Wales and Northern Ireland.
The commission is expected to treat Letby’s case as a priority given the public interest. But it is still likely to take at least a year to review the considerable evidence before a referral back to the Court of Appeal could even be considered.
What evidence will be considered?
The CCRC aims to complete cases within 12 months of receiving the application. But the organisation has recently come under criticism over how it handled the case of Andrew Malkinson, who was wrongly jailed for 17 years for a crime he did not commit.
When the CCRC considers the full application, they have the power to refer the case back to the Court of Appeal. In order to do so, the commission requires new evidence or other relevant factors which would support a fresh appeal.
The findings of the medical panel will be part of the defence submission. The CCRC will decide, with other factors, whether they constitute fresh grounds for an appeal. It is particularly compelling that the prosecution case relied on Dr Lee’s research, and yet it is in part his expertise that has become a crucial element of the defence.
To send the case back for appeal, the CCRC would also need to conclude that there was a “real possibility” of the conviction being overturned.
It is important to remember that the case against Letby included statistical and circumstantial evidence as well as medical opinion. However, what are alleged to be numerous fallacies in the statistical evidence have been highlighted. And circumstantial evidence is just that – circumstantial. Letby was convicted on the medical evidence.
The evidence given as part of the Thirlwall Inquiry will be within the remit of the CCRC too. Although the inquiry has not yet formally concluded, all oral testimony has taken place. As would be expected given the inquiry’s terms of reference, much of the evidence heard has been less favourable to Letby.
The CCRC also has the power under the Criminal Appeals Act 1995 to instruct its own expert witnesses and interview previous and potential new witnesses.
If the CCRC ultimately decides to refer the case to the Court of Appeal, it will be treated like any other appeal. It could result either in the conviction being quashed and Letby going free, or a retrial.
A retrial would follow if the appeal judges believed that a retrial met the criteria set out in the Criminal Appeal Act 1968 and was in the interests of justice. The likelihood of this outcome depends on the strength of the medical evidence presented to the CCRC and the Court of Appeal.
Read more: Lucy Letby case: the problems with expert evidence
As the Thirlwall Inquiry and the CCRC application are separate processes, is it technically not essential that the inquiry concludes before the CCRC makes a decision. Closing submissions to the inquiry are scheduled for March 2025, with the report expected later in the year. This should fit within the expected timeframe of the CCRC taking at least a year to consider the application.
A further complicating factor is Lee’s assertion that the Countess of Chester hospital provided such bad care that it would have been “shut down” in his home country of Canada. This will no doubt lead to legal claims against the NHS trust, particularly if Letby is exonerated and culpability for avoidable deaths is sought elsewhere.
Some, including Lee, have gone so far as to suggest the new evidence is so compelling that Letby should be released on house arrest pending the CCRC review. This would be highly unusual, and for the time being, Letby remains imprisoned as one of the worst child serial killers in modern British history.
Daniel Alge does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
