Why it matters in the Letby case
Post-trial commentary has examined how the RCPCH review's findings were used at trial and whether the review's scope supports the inferences placed on it.
Institutional explainer
The 2016 RCPCH invited review
The 2016 RCPCH invited review of the Countess of Chester neonatal unit identified clinical-care concerns but did not identify a perpetrator. Its terms of reference were defined by the Trust.
Commentary5Commentary
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Prosecution position
The review's findings on clinical care and unit capacity were part of the background against which the case was investigated and tried.
Expert challenge / post-conviction reading
In September 2016 seven consultant paediatricians wrote to Trust executives demanding the police be called. The executives commissioned a service-level review from the Royal College instead. The review's authors later told the Thirlwall Inquiry about the framing they were given.
What remains uncertain
A review scoped to service delivery cannot identify a perpetrator, and this one did not. What it can bear on is contested: its terms of reference were set by the body being reviewed.
Common questions
What did the 2016 RCPCH review find?
Concerns about clinical care and unit capacity. It did not identify a perpetrator, and it was not scoped to do so.
Who set its terms of reference?
The Trust. That is the point most often made about it — the body under scrutiny defined the scope of the review into itself.
Why was a review commissioned rather than the police called?
Seven consultants had asked for police involvement in September 2016. The executives commissioned the review instead. The sequence is documented in the Inquiry record.
Is the review evidence of innocence or of guilt?
Neither. It is a service review, and its findings cannot bear on what happened to an individual baby.
Related reading
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