Lucy Letby and Dr Ravi Jayaram: The doctor who helped catch serial killer nurse
Dr Ravi Jayaram has received widespread praise for his part in alerting hospital authorities and the police to nurse Lucy Letby's child-murder spree.
Having noticed a pattern between baby deaths and Letby's presence, Dr Jayaram repeatedly called for action, but he says he was consistently ignored and even told to apologise to Letby.
Dr Jayaram believes he walked in on Letby after one of her attacks - on a baby girl who died three days later - and has now called for a public inquiry into Letby's crimes.
Yahoo News UK looks into Dr Jayaram's background and how his actions led to Letby's arrest and subsequent convictions for murder.
Who is Dr Ravi Jayaram?
Dr Jayaram has worked as a paediatrician since 1992. He is a consultant paediatrician at the Countess of Chester Hospital, where Letby killed at least seven babies, and attempted to kill at least six more.
Having completed his undergraduate training in Newcastle-upon-Tyne, Dr Jayaram trained in the north east of England, Bristol, New South Wales and London.
He specialises in the treatment of asthma, cystic fibrosis, and other childhood lung disorders.
Dr Jayaram appears regularly on TV and radio in his capacity as a medical expert, and co-presented Channel 4’s series Born Naughty? as well as appearing on the Channel 4 health series How to stay well. He has also presented episodes of the Accelerating Health podcast.
A keen triathlete, he is believed to be married with one young son.
How did Dr Jayaram know Lucy Letby?
The pair worked together at the Countess of Chester Hospital in Cheshire. Dr Jayaram told the jury at Letby's trial that he became concerned when he walked in on Letby standing over the incubator of a newborn girl whose oxygen levels had fallen “dangerously” low.
He said he had been “uncomfortable” that Letby was alone with the 12-week premature baby because he had “started to notice a coincidence between unexplained deaths, serious collapses and the presence of Lucy Letby”.
Dr Jayaram rushed to help the infant and found that her chest was not moving and her breathing tube had been dislodged. He said Letby was “making no effort to help” the baby and had not called for assistance, while an alarm connected to the child appeared to have been silenced.
The paediatrician said he was “troubled” because Letby was the only person in the room. The baby, known as Child K, died three days later of an unrelated complication. Letby was not charged with murder - the jury could not reach a verdict on the charge of attempted murder.
What has Dr Jayaram since said about the murders?
Dr Jayaram claims he repeatedly raised concerns to the Countess of Chester Hospital NHS Foundation Trust about the increase in deaths, and Letby's presence at the time, yet it was almost two years after the first babies died before police were eventually contacted by the trust.
Watch: Dr Jayaram says Letby concerns were repeatedly ignored
In a Facebook post on 18 August, the day Letby was found guilty, Dr Jayaram said: "The truth of what happened during that time will shock you to the core as it comes out. The safety of patients should come above any risk of reputational damage and sometimes the right decisions might be difficult and unpopular, but executive level managers are paid to do just that. There are people out there now, still earning six figure sums of tax-payers money or retired with their gold-plated pensions, who need to stand up in public to explain why they did not want to listen and do the right thing, to acknowledge that their actions potentially facilitated a mass-murderer and to apologise to the families involved in all of this. However, I suspect the response will be fudge and misinformation and it is now my mission moving forwards to make sure that they are held to account.
"There is a long history of whistleblowers who raise concerns in the NHS not only being ignored but then being portrayed as the problem, sometimes to the point of their careers being destroyed. What happened here was history repeating itself but the patient safety issue that was ignored was beyond anything that the NHS has tried previously to cover up. There needs to be fundamental change in the culture and governance of NHS institutions and it should start right now."
A tearful Dr Jayaram told ITV News: “I do genuinely believe that there are four or five babies who could be going to school now who aren't."
He said consultants first began raising concerns after three babies died in June 2015.
As more infants collapsed and died, he and several consultant colleagues attended meetings with hospital executives to raise their concerns about Letby.
Dr Jayaram claims he was told to “draw a line under the 'Lucy issue'” and to apologise to her for alleged 'victimisation'.
He also says that the then-Chief Executive of the trust, Tony Chambers, told consultants at the meeting in January 2017: “I'm drawing a line under this, you will draw a line under this, and if you cross that line, there will be consequences for you.”
When doctors suggested going to the police with their concerns, hospital executives are said to have warned them that it would result in “blue and white tape” all over the ward, damaging the reputation of the trust.
Labelled a hero by the parents of victims, and police, for pursuing the case despite months of inaction by the trust, Dr Jayaram said in an interview with ITV News: "I was just doing my job."
What did the hospital do about the allegations?
Letby was eventually moved off the neonatal unit at Countess of Chester, leading her to take out a grievance against the trust.
The panel concluded that the doctors had made “unsubstantiated comments” and executives advised Dr Jayaram and his colleagues to apologise to Letby to avoid facing a possible referral to the General Medical Council.
In May 2017, Cheshire Police announced they were launching an investigation following “a greater number of baby deaths and collapses” at the hospital between June 2015 and June 2016.
Letby was first arrested on 3 July 2018, then rearrested on 10 June 2019, four years and two days since the first murder. She was released without charge, then arrested again in November 2020 and charged two days later.
Her trial began in October 2022 and on Monday 21 August she was sentenced to life imprisonment without parole.
Why is Dr Jayaram calling for a public inquiry?
After Letby's conviction, the government announced that a non-judicial inquiry into the former nurse's crimes would be launched, with Rishi Sunak telling broadcasters it should "happen as quickly as possible".
Watch: Statutory inquiry into Lucy Letby killings will ensure accountability
A non-judicial inquiry would mean witnesses would not be obliged to attend if called, and rulings would not have legal weight.
Dr Jayaram has questioned whether a non-statutory inquiry will provide conclusions that lead to "meaningful change" in how the NHS responds to patient safety concerns.
He told ITV News: "I think the fact that it is a non-statutory inquiry just makes me angry more than anything else."
"Why should it not be a non-statutory inquiry?," he asked. "There have been other inquiries into NHS scandals which have been statutory full public inquiries. Why on earth would this be announced as a non-statutory inquiry?
"We have to look really at what we want to get out of an inquiry. For resolution for the parents, the quicker the better, but is the priority speed?
"I would much rather have an inquiry that asked the right questions and took as much time as it needed to get the right answers."
What have key people at the hospital said?
Alison Kelly, who was director of nursing at the Countess of Chester Hospital before leaving in 2021, has been suspended from her current role, nursing director at the Northern Care Alliance NHS Foundation Trust in Salford, following claims she ignored concerns about Letby.
The Nursing and Midwifery Council (NMC) said she has now been referred to the fitness to practise process.
The chief executive of the hospital trust, Tony Chambers - who served six years in his post before he resigned in September 2018 - said in a statement following the verdicts: “As chief executive, my focus was on the safety of the baby unit and the wellbeing of patients and staff. I was open and inclusive as I responded to information and guidance.”
The current medical director, Dr Nigel Scawn, said "significant changes” have been made to services since Letby worked at the hospital, adding: "Our staff are devastated by what has happened and we are committed to ensuring that lessons continue to be learned.”
At the time she carried out the attacks, the hospital’s medical director was Ian Harvey. He said: “As medical director I was determined to keep the baby unit safe and support our staff. I wanted the reviews and investigations carried out so that we could tell the parents what had happened to their children.