Lucy Letby: What have we learnt from the first week of the trial?

The trial of a nurse accused of multiple baby murders while working on a neonatal unit has begun.

Lucy Letby, 32, faces 22 charges including the murder of five boys and two girls.

She is also accused of 15 counts of attempted murder of another five boys and five girls, between June 2015 and June 2016, with some allegations referring to repeated attempts on the same baby.

It is claimed Letby, originally from Hereford, went on a year-long killing spree while working at the Countess of Chester Hospital in Cheshire.

A court order prohibits reporting of the identities of surviving and deceased children allegedly attacked by Letby, and prohibits identifying the parents or witnesses connected with the children.

The trial is expected to last up to six months.

In week one of the the trial at Manchester Crown Court, from 9-14 October, the prosecution began by opening the case.

Letby's defence also read an introductory statement.

What did the court hear?

The jury of five men and nine women heard that the collapses and deaths of the 17 children at the hospital neonatal unit were not "naturally-occurring tragedies" but the work of a "poisoner".

Prosecutor Nick Johnson KC said: "Having searched for a cause, which they were unable to find, the consultants noticed that the inexplicable collapses and deaths did have one common denominator.

"The presence of one of the neonatal nurses and that nurse was Lucy Letby.”

Jurors were told she allegedly deployed various means to attack the youngsters, including insulin poisoning and injecting air into the bloodstream.

Letby told one parent "trust me, I'm a nurse" in an attempt to 'fob her off' as she was murdering her baby, a court has heard.

Following his death in the early hours of 4 August, the Crown said Letby made "fraudulent" nursing notes which were "false, misleading and designed to cover her tracks".

Letby is also accused of trying to kill a premature baby girl four times before succeeding - and then sending a sympathy card to the grieving parents.

In another case, the prosecution say Dr Ravi Jayaram, a paediatric consultant, decided to check on the nurse after he noticed a "coincidence between the unexplained deaths, serious collapses and the presence of Lucy Letby".

Dr Jayaram found the child's, known as child K, chest was not moving and asked Lucy Letby if anything had happened.

She was said to have replied: “She’s just started deteriorating now.”

On a piece of paper found in her home, Letby wrote "I killed them on purpose... I am a horrible evil person", the court has heard.

Letby also wrote "I am evil, I did this" in capital letters on another note which was found among papers and Post-it notes in a search of her home by police.

The defence also opened their case on Wednesday 12 October. 

Lucy Letby was a "dedicated nurse" who "in no way" wanted to harm the babies she was looking after, Ben Myers KC, defending, said.

He told Manchester Crown Court that it was a "theory of guilt based firmly on coincidence", with premature babies also collapsing when she was not on shift.

"The fact that Lucy Letby has been present at the time of the deterioration of a child has itself become the explanation of that deterioration," he added.

"Even though there's no evidence to show she has caused that to happen."

Giving the jury a "short introduction" to the defence case, Mr Myers said Letby worked at a hospital which he suggested was "overstretched and understaffed", highlighting problems with the way the neonatal unit was run.

He cited the Post-it note, mentioned in the prosecution opening.

"This is the anguished outpouring of a young woman in fear and despair when she realises the enormity of what’s being said about her, in the moment to herself," Mr Myers said.

The Post-it note, enlarged and shown on screens to the jury, included the words: "Not good enough. I’m an awful person. I will never have children or marry. Despair", and "I haven’t done anything wrong".

Ben Myers KC, pointing to Letby sitting in the dock, told jurors: "It is important to be careful that blame is not heaped on that woman when there may be others who have made mistakes or a system which has failed."

Letby denies the allegations. The trial continues.