Context
The CCRC application is accompanied by expert reports from clinical psychologists addressing the psychology of self-blame writing by clinicians accused of serious harm in their professional setting. This page summarises the substance of those reports.
The central question
The expert question addressed is narrow and precise: given the features of the Letby Post-it notes (private, not addressed to any audience, written at home during a period of sustained institutional accusation, containing oscillating statements of denial and crushing self-blame on the same page), do those notes constitute evidence of guilt, or are they consistent with a recognised psychological pattern in accused clinicians?
The expert position
The position advanced in the CCRC expert reports can be reduced to four findings:
- Self-blame writing is a recognised pattern. The clinical-psychology literature has documented, for over three decades, that people under sustained accusation — particularly in professional contexts where they cannot effectively rebut the accusation — commonly produce private self-blame writing. This is not evidence of guilt; it is evidence of the accusation environment.
- Personality structure predisposes. Nurses and doctors are disproportionately drawn from a personality population scoring high on conscientiousness and neuroticism. Under sustained accusation, these traits are associated with self-blame rather than self-defence responses.
- Oscillation is the signature. Private writing by people under sustained accusation characteristically oscillates between denial and crushing self-blame — sometimes on the same page, sometimes within the same sentence. Consistent admission is the exception, not the rule.
- Clinical-staff-accused contexts are specific. The literature documents this pattern specifically in nurses accused of patient harm, in doctors facing fitness-to-practise investigations, and in care-home staff facing abuse allegations. The pattern does not predict guilt or innocence; it predicts the presence of sustained accusation.
What a forensic confession would look like
A confession, in criminal-law terms, identifies the victim, the method, the time and place, and the motive. It is written in a purposeful register. It is often intended for an audience. The Letby notes do none of these things. They were kept entirely privately, on Post-its at home, and never shared. This distinguishes them, sharply, from the confessional text the Crown framed them as.
Historical precedent
The Grantham case (Beverley Allitt), the Vaud Hospital investigations in Switzerland, the Lucia de Berk case in the Netherlands, and several other accused-clinician investigations have all produced private self-blame writing by clinicians who were ultimately either exonerated or who, if convicted, were convicted on independent forensic evidence rather than on the notes themselves. The notes were, in each case, diagnostic of the environment the clinician was in, not of the charge.
Read alongside
Our self-blame psychology analysis, Full-context reading of the notes, Evidence: the handover notes, CCRC review timeline.