A public inquiry has started in the United Kingdom into how a nurse murdered seven newborns at the hospital she worked at and why the killings went unnoticed for months.

The government-ordered proceedings into the case of 34-year-old former nurse Lucy Letby, found guilty of murdering the infants in her care at Chester’s Countess of Chester Hospital in northern England from 2015-2016, began on Tuesday in Liverpool Town Hall.

Opening the session, chairwoman Lady Justice Kathryn Thirlwall said Letby’s conviction last year had not brought full closure to victims’ families and that it was the inquiry’s task to seek answers for them.

“At the heart of this inquiry is the babies who died, who were injured and their parents,” said the senior judge.

Letby was convicted to a life term for murdering seven babies and attempting to kill seven others in the hospital’s neonatal unit where she worked after two trials. She was refused an appeal bid earlier this year.

The case made headlines across the country and prompted the government to order the independent inquiry into her hospital, including its response to concerns raised about Letby before her arrest.

Called the Thirlwall inquiry, the probe will zero in on the circumstances surrounding the murders and attempted murders by Letby, asking whether governance contributed to the failure to protect the babies.

The inquiry into the wider circumstances around the case will include the response and conduct of the National Health Service (NHS), its staff and its regulators.

The participants will include the hospital’s former director of nursing, Alison Kelly, who was suspended from her role for failing to act on doctors’ complaints about Letby, and other staff.

Hopes for a new appeal

The inquiry begins as Letby looks to a new defence team, headed by Mark McDonald, hoping for a new appeal.

McDonald, who previously represented a nurse accused of killing two of his patients and poisoning 15 others in 2006, told the BBC “there is a strong case that she [Letby] is innocent”, with new medical evidence, hospital statistics and expert analysis revealing holes in the case against her.

He said he aims to put her case before the Criminal Cases Review Commission (CCRC), asking for it to be returned to the Court of Appeal.

The independent inquiry comes amid scrutiny of the conviction and Letby’s new lawyer revealing that she was planning a new appeal [File: Phil Noble/Reuters]

Lawyers representing some of the victims’ families say the speculation about Letby’s guilt or innocence, some of which has taken place on social media, has been distressing.

At the inquiry’s opening, Thirlwall stressed: “It is not for me to set about reviewing the conviction – the court of appeal has done that – the convictions stand.”

Prosecutors said Letby killed the infants by overfeeding them with milk, poisoning them with insulin, or injecting them with air in the neonatal unit.

A handwritten note found in her home read: “I am evil, I did this.”

Letby was sentenced to life without parole last year and in July was found guilty of a seventh charge of attempted murder, on which the original jury could not reach a verdict.

During her initial sentencing, Justice Gross of Manchester Crown Court, said, “You acted in a way that was completely contrary to the normal human instincts of nurturing and caring for babies.”

Letby has always denied harming any child in her care and – despite the jury’s verdicts and the rejection of her bid to appeal – her case has become a cause celebre, based on criticism of medical and statistical evidence presented at trial.

The inquiry hearings are expected to continue until at least the end of the year. Thirlwall will present a report but cannot make any findings of civil or criminal liability.