UK - Nurse Lucy Letby, Faces 22 Charges - 7 Murder/15 Attempted Murder of Babies #23

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The history from birth to death/ collapse surely is not that relevant...because despite all the said history..and other possibilities each medical expert has summarised their overall cause of death and why.
The jury are not going to try and make their decision on all the history and symptoms they will use the cause presented
The problem with baby c is that the cause presented by the experts has chopped and changed with regards to what occurred when, and even to the extent of dr evans mentioning for the first time ever on the stand (and not in any of his previous 8 reports ) that there was a splinting of the diaphragm.
 
The problem with baby c is that the cause presented by the experts has chopped and changed with regards to what occurred when, and even to the extent of dr evans mentioning for the first time ever on the stand (and not in any of his previous 8 reports ) that there was a splinting of the diaphragm.

He did explain though that as more information comes in right through to anything he heard in court the diagnosis can change..exactly the same way that it does when a person is having tests etc when they are unwell.
I'm not suggesting every single case will be clear cut. It will obviously down to the Jury to decide...but medical "history" is not what should be used to make that decision its the experts "final" conclusion
 
Not sure. I think it's been mentioned that she can't canfer with her legal team during her testimony.
I think remand prisoners have more rights that convicted prisoners. I always thought they were allowed daily visits but I see that at HMP Styals state that remand prisoners are only allowed three visits per week in their facility. I don't know whether it's different when the defendent is testifying under oath. But I would expect her to be able to have access to visits throughout the trial. It would seem unreasonable to have a remand prisoner have to no visits for 8 months.
I do think that those who are supporting her are reading online material and potentially feeding back ideas of public opinion. Which is why it was annoying that some members of the public spent the duration of the prosecution, presenting 'new ideas' of what the unheard defenses evidence might be and why it's important that we don't 'pr empt' explanations for the defence, whilst they are still giving evidence. Jmo
 
If as the prosecution stated -

"What we are going to see as we progress is that Lucy Letby’s method of attacking the babies in the neonatal unit was beginning to develop," Mr Johnson tells the court.

and

"These were not naturally occurring, or random events; they were deliberate attempts to kill using a slightly different method by whilst Lucy Letby sought to give the appearance of chance events in the neonatal unit at the Countess of Chester Hospital."

Recap: Prosecution opens trial of Lucy Letby accused of Countess of Chester Hospital baby murders

- and if (allegedly) LL had already killed babies A and D with air embolisms, and was conscious that colleagues were talking about unexpected and unexplained deaths,

- and if baby E died from air embolism and bleeding from throat injury,

it's possible the bleeding (before follow-up injection of air) was intended to point towards haemmorhage and draw attention away from another unexplained death. IMO

Baby E's mum turned up slightly earlier than expected for the feed, and could have interrupted an alleged plan to inject air at that time. The experts allege that air was injected a few hours later, causing his collapse.

I tried to imagine a scenario where LL asks mum to leave, and then immediately injects air, causing a collapse. The mum would have to be called back because it's a life-threatening situation, and she tells the doctor, 'I was here just 10 minutes ago and he was bleeding and screaming, and nurse sent me back to my ward'. The doctors are going to think well if he was bleeding and screaming 10 minutes ago, why did LL tell mum to go, and why didn't LL bleep us, and his collapse isn't related to the extent of bleeding that they can see at that time. So I think LL could have been surprised by the mum's early visit, and waited a while to see if anyone would come. Then when they didn't, she decided to report the bleeding to a doctor 40 minutes later, because the mum knew, the mum also knew he hadn't collapsed, and mum or dad could contact the ward for an update.

Allegedly and speculatively and if she is proven guilty.
My thoughts on baby E were that it was a plan gone wrong indeed. I think that the injuries caused were intended to be further down the babies airway and were meant to present as discoluration across the abdomen. To achieve this effect would set a baby on the a good trajectory for a NEC diagnosis. We'd see a discolouration across the abdomen, desats and Brady's from the blood loss, also making it look like NEC.
But somehow, the baby ended up getting injured higher up, or the baby had a natural reflux which caused the blood to become visible in the wrong way and this is what the mother noted.
LL was caught off guard by the visit by the mum. The baby wasn't meant to 'show symptoms' until the drs round and it was meant to be a 'discoloured abdo' so a change of tact was employed an an AE administered and the bloody aspirate produced after she could leverage as much time as possible.
Remarkably, the Dr bought the 'bloody aspirate' story as symptomatic of a gasteral intestinal bleed. I have mixed feelings about what was done with that information.
 
My thoughts on baby E were that it was a plan gone wrong indeed. I think that the injuries caused were intended to be further down the babies airway and were meant to present as discoluration across the abdomen. To achieve this effect would set a baby on the a good trajectory for a NEC diagnosis. We'd see a discolouration across the abdomen, desats and Brady's from the blood loss, also making it look like NEC.
But somehow, the baby ended up getting injured higher up, or the baby had a natural reflux which caused the blood to become visible in the wrong way and this is what the mother noted.
LL was caught off guard by the visit by the mum. The baby wasn't meant to 'show symptoms' until the drs round and it was meant to be a 'discoloured abdo' so a change of tact was employed an an AE administered and the bloody aspirate produced after she could leverage as much time as possible.
Remarkably, the Dr bought the 'bloody aspirate' story as symptomatic of a gasteral intestinal bleed. I have mixed feelings about what was done with that information.

You seem very knowledge about the baby’s condition. I have a question, but of course you are under no obligation to answer it!

I read in one of the previous articles posted that the baby had 15 cc’s of blood aspirated from the stomach around this time. Was it ever determined exactly where the blood came from? In an adult it could be due to a ruptured stomach or esophageal ulcer. Did the post-mortem exam show the source of the bleeding?

I worked in a NICU in the US for 20 years ( though granted this was 15 years ago!) and do not recall ever seeing a baby bleed out like that from the upper GI system. There doesn’t seem any indication the baby was in DIC (disseminated intravascular coagulation) or had any other clotting abnormality.

Curious what your thoughts are.
 
You seem very knowledge about the baby’s condition. I have a question, but of course you are under no obligation to answer it!

I read in one of the previous articles posted that the baby had 15 cc’s of blood aspirated from the stomach around this time. Was it ever determined exactly where the blood came from? In an adult it could be due to a ruptured stomach or esophageal ulcer. Did the post-mortem exam show the source of the bleeding?

I worked in a NICU in the US for 20 years ( though granted this was 15 years ago!) and do not recall ever seeing a baby bleed out like that from the upper GI system. There doesn’t seem any indication the baby was in DIC (disseminated intravascular coagulation) or had any other clotting abnormality.

Curious what your thoughts are.
Dbm
 
One thing I’m unclear on is when dr bohin reviewed the work done by dr evans with regards to causes of death.

Was she brought in just before the trial began to review all the conclusions as at that time? Or was she brought in one /two years before trial to review the conclusions ?

Given that dr evans has changed his opinion for various cases between various reports , I would be interested to know how dr Bohin’s reviews and conclusions compare to dr evans’. For example , where dr E writes a report which reaches a particular conclusion , has dr bohin looked at that report and pointed out something else in the evidence , which dr evans didn’t spot and so dr evans changes his opinion? Or has dr bohin always agreed with whatever conclusions dr evans’ report at the time reached?

Just interested in how the roles of dr evans and dr bohin fit together and have worked in practice to shape the current charges and arguments
 
Hi. Not medical here as my experience is from having a 25 weeker myself with NEC and working strategically in the NICU field for around 12 years..
I've never come across a GI bleed in a neonate. Unsuprising given that Bohen advised that there were only 6 cases recorded globally in history.
Re where the blood came from, I think this was overlooked by harkness as he was too busy dealing with the AE.
He didn't admit to negligence but he did say that since leaving CoC he realises that what he saw is not normal and only thought it normal due to working at CoC.
That is one of the hardest things with this case.
Why these babies were not 'flagged' as unusual as the story unfolded. It's honestly heartbreaking.
 
He did explain though that as more information comes in right through to anything he heard in court the diagnosis can change..exactly the same way that it does when a person is having tests etc when they are unwell.
I'm not suggesting every single case will be clear cut. It will obviously down to the Jury to decide...but medical "history" is not what should be used to make that decision its the experts "final" conclusion
My problem with baby C and Doctor Evans’ evidence is that he hasn’t been reported as giving a detailed explanation of what new information he has received which has caused him to change his previous conclusion.

(Side note : this may well simply be down to the inherent limitations of following a criminal trial via live tweeting of various reporters. Maybe he provided a full explanation, but it hasn’t been reported, in which case I will stand corrected.)

We are dealing with scientists and doctors, who by their very nature are concerned with details and hard evidence. I would therefore expect detailed analysis regarding conclusions , particularly changing conclusions, to be provided .

So if Dr Evans says that he wrote seven reports which concluded air embolism was given on 12 June 2015, but then he received a new piece of information, which he then describes and explains how that has changed his conclusions, and report number eight then says air embolism happened after the 12th June 2015, then I don’t have a problem with that. That makes sense to me.

Equally, if Dr Evans wrote one opinion, and then it wasn’t that he received new evidence, but he realised that he had missed a piece of the existing evidence, which had then caused him to change his opinion, then I wouldn’t have a problem with that either. Indeed, in the case of two of the babies (not baby C), I believe Myers pulled him up on his changing report and Dr Evans said that he had “ overlooked” a particular piece of evidence when he did his first report - I don’t have a problem with that. Obviously it’s not great for experts to overlook things, but as long as they do pick things up before key moments such as trial, then no real harm done.

With baby c, all that Dr Evans is reported as providing in the way of an explanation is that he changed his mind after “taking into account all the other evidence and information from experienced medical people's reports, and reading the pathology report”. There’s no detail behind what report or evidence has caused him to change his mind . That is what I have a problem with.

Dr Evans specifically says in relation to baby c and infection being a cause that if additional evidence emerges, he will take that into account. Myers pointed out that dr evans hadn’t received any new evidence on baby c’s infection since that report.
 
He did explain though that as more information comes in right through to anything he heard in court the diagnosis can change..exactly the same way that it does when a person is having tests etc when they are unwell.
I'm not suggesting every single case will be clear cut. It will obviously down to the Jury to decide...but medical "history" is not what should be used to make that decision its the experts "final" conclusion
Add to that the defendant's changing evidence.

evidence in chief -

Ms Ellis said she went briefly to the nurses' station and whilst there she heard Child C's monitor sound an alarm. When she re-entered nursery one, Ms Letby was already standing next to the cot and told her: "He's just dropped his heart rate and saturations."

Ms Letby says she does not recall saying that or recall when she entered nursery one

https://twitter.com/MrDanDonoghue

Letby tells the court she has no recollection of any of the events leading up to Child C's collapse. She says it was "a normal shift" and has "no memory" of what happened until Child C's collapse, which was a "significant event".

Letby is asked why she can now confirm she was in room 3 of the nursery, having not been able to remember to that in police interview. Letby says she was able to remember being in nursery room 3 after since being made aware of which babies were in room 3 that night.

She says she was said to have been in room 1 based on the statement by Sophie Ellis, but she tells the court she had not been in that room prior to Child C's collapse. She says she had been 'put' in that room 1 based on Sophie Ellis's statement.

Recap: Lucy Letby trial, Friday, May 5 - defence continues

Cross-exam -

Johnson then says: "Have you ever sent texts to your friends while performing a tube feed?" Letby replies: "No, absolutely not."
Johnson asks: "Where would that fall in the scale of infractions?"
Letby responds: "It would be inappropriate and I don’t know how you could do a feed without using both hands."

https://www.bbc.co.uk/news/live/uk-65602988/page/3


Mr Johnson says text messages were exchanged between Letby and Jennifer Jones-Key between 11.01pm and 11.09pm.
Letby says she does not accept she was in room 1 at the time of Child C's collapse. She says she has "no memory" of it.

Letby says she "disputes" that, as she has "no memory" of it.

Letby is asked why she let a band 4 nursery nurse look after her designated baby.
Letby says it's "not unusual" for band 4 nurses to assist her in her duties.
LL: "I have no memory of that".
Mr Johnson says the text at 11.01pm sent by Letby to Jennifer Jones-Key meant she must not have been in a clinical area, and would not have had time to feed her designated baby in room 3.
LL: "I can't answer that."
Mr Johnson says it took her out of the nursing area. Letby said she would have been "in the doorway" of the unit.

Recap: Lucy Letby trial, May 19 - cross-examination continues
 
Hi. Not medical here as my experience is from having a 25 weeker myself with NEC and working strategically in the NICU field for around 12 years..
I've never come across a GI bleed in a neonate. Unsuprising given that Bohen advised that there were only 6 cases recorded globally in history.
Re where the blood came from, I think this was overlooked by harkness as he was too busy dealing with the AE.
He didn't admit to negligence but he did say that since leaving CoC he realises that what he saw is not normal and only thought it normal due to working at CoC.
That is one of the hardest things with this case.
Why these babies were not 'flagged' as unusual as the story unfolded. It's honestly heartbreaking.

Thanks very much for your reply and patience. I am slowly reading articles and listening to the podcast. There’s so much information to wade through.

I agree those babies should have been flagged in some way, for further investigation.
 
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My problem with baby C and Doctor Evans’ evidence is that he hasn’t been reported as giving a detailed explanation of what new information he has received which has caused him to change his previous conclusion.

(Side note : this may well simply be down to the inherent limitations of following a criminal trial via live tweeting of various reporters. Maybe he provided a full explanation, but it hasn’t been reported, in which case I will stand corrected.)

We are dealing with scientists and doctors, who by their very nature are concerned with details and hard evidence. I would therefore expect detailed analysis regarding conclusions , particularly changing conclusions, to be provided .

So if Dr Evans says that he wrote seven reports which concluded air embolism was given on 12 June 2015, but then he received a new piece of information, which he then describes and explains how that has changed his conclusions, and report number eight then says air embolism happened after the 12th June 2015, then I don’t have a problem with that. That makes sense to me.

Equally, if Dr Evans wrote one opinion, and then it wasn’t that he received new evidence, but he realised that he had missed a piece of the existing evidence, which had then caused him to change his opinion, then I wouldn’t have a problem with that either. Indeed, in the case of two of the babies (not baby C), I believe Myers pulled him up on his changing report and Dr Evans said that he had “ overlooked” a particular piece of evidence when he did his first report - I don’t have a problem with that. Obviously it’s not great for experts to overlook things, but as long as they do pick things up before key moments such as trial, then no real harm done.

With baby c, all that Dr Evans is reported as providing in the way of an explanation is that he changed his mind after “taking into account all the other evidence and information from experienced medical people's reports, and reading the pathology report”. There’s no detail behind what report or evidence has caused him to change his mind . That is what I have a problem with.

Dr Evans specifically says in relation to baby c and infection being a cause that if additional evidence emerges, he will take that into account. Myers pointed out that dr evans hadn’t received any new evidence on baby c’s infection since that report.

I think think the expert witness can change their mind as many times as they like and liaise with experts to help form their views but they must disclose it.

"where the expert has based an opinion or inference on a representation of fact or opinion made by another person for the purposes of criminal proceedings (for example, as to the outcome of an examination, measurement, test or experiment);(i) identify the person who made that representation to the expert, (ii) give the qualifications, relevant experience and any accreditation of that person, and (iii) certify that that person had personal knowledge of the matters stated in that representation;"

32.4 (section E)


Edited to say, posts have been added whilst I trawled through to find this but the website is still useful for understanding medical expert witnesses.
 
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One thing I’m unclear on is when dr bohin reviewed the work done by dr evans with regards to causes of death.

Was she brought in just before the trial began to review all the conclusions as at that time? Or was she brought in one /two years before trial to review the conclusions ?

Given that dr evans has changed his opinion for various cases between various reports , I would be interested to know how dr Bohin’s reviews and conclusions compare to dr evans’. For example , where dr E writes a report which reaches a particular conclusion , has dr bohin looked at that report and pointed out something else in the evidence , which dr evans didn’t spot and so dr evans changes his opinion? Or has dr bohin always agreed with whatever conclusions dr evans’ report at the time reached?

Just interested in how the roles of dr evans and dr bohin fit together and have worked in practice to shape the current charges and arguments
All the experts said the air on June 12th could have been put there deliberately - Professor Arthurs, Dr Evans and Dr Bohin. None of them have said they no longer think that, but at the same time none of them say it caused his death, because his abdomen was noted to be soft and not distended all day on the day of his death.


Mr Myers says the 2019 report said Dr Evans raised a possibility of deliberate injection of air from June 12 via the naso-gastric tube.
Dr Evans, reflecting on that report, said: "Can't rule it out".

He tells the court: "However the air went in, it would have been insufficient to splinter the diaphragm on the 12th, as he would've collapsed and died on the 12th."

The air which had gone in was 'insufficient' to cause a collapse. There was 'nothing to suggest' the excess air was enough on June 12.

He says the two events on June 12 and 13 "are quite different" in the way they happened.

He adds that in coming to his conclusion for this case he is not relying solely on his opinions, but taking in other clinical evidence and reports.
"That is what doctors do, we do it all the time." in what Dr Evans says is a "complicated case"

Recap: Lucy Letby trial, Tuesday, November 1



Dr Bohin says her role was not to 'rubber-stamp' anything, but to come to her own conclusions and see whether they agreed with that of Dr Evans.

Recap: Lucy Letby trial, Tuesday, November 1

Asked to explain a build-up of gas in Child C’s abdomen detected on a X-ray on June 12the day before his fatal collapse – Dr Bohin said air could have accumulated via respiratory support he was receiving. The alternative explanation is a deliberate introduction of air down a fitted nasogastric tube, she said.

- https://www.chesterstandard.co.uk/news/23096234.lucy-letby-trial-murder-accused-nurse-told-police-found-babys-lingering-death-quite-hard/


For Child C, the defence say it is accepted that someone had injected air as a "theoretical possibility", but that is "a very long way from proving what has taken place". Mr Myers said the jury would have to look at the practicalities of that, and consider alternative explanations. Child C was "subject to a variety of complications" due to being born premature, the jury is told. "We say, for a starting point, he should have been at a unit providing more specialist care." The defence say pathology identified acute pneumonia in Child C. The defence suggest a structural blockage could have caused distention.

Lucy Letby trial recap: Prosecution finishes outlining case, defence gives statement


Professor Arthurs, asked by the prosecution about a bowel obstruction, says if the bowel was blocked at a particular point, it would give a 'marker' of where the obstruction was.
He says the image shows no such marker, and as bowel obstructions are a 'common clinical occurrence', it would be diagnosed and babies would go to theatre for an operation.
He says there is no evidence of a bowel obstruction on the imaging, on the clinical notes, or in an autopsy.
Referring to the possibility of a twisted bowel, which he says 'can happen in small babies' and result in a blockage. He says that is often a surgical emergency, and would be documented as such, and found post-mortem if there is such a finding.

Recap: Lucy Letby trial, Friday, November 11

Dr Marnerides – podcast - baby c was the next case the doctor examined. A post-mortem carried out at the time concluded that baby c died from pneumonia and in fact when Dr Marnerides initially reviewed the case in 2019 he agreed with this, but later he changed his mind, after reading more medical reports. He told the court that baby c did have pneumonia but he was stable and responding to treatment and his collapse was therefore unexpected. He also said baby c’s tummy had ballooned. He concluded that baby c died as a result of having an excessive quantity of air injected into his stomach and that air had led him to being unable to breathe and suffering a cardiac arrest. His final view was that baby c died with pneumonia not from pneumonia. The Trial of Lucy Letby, Episode 26: Unnatural Causes? - The Mail
 
Thanks for bringing those threads together, on the point made by Myers.
"We say, for a starting point, he should have been at a unit providing more specialist care."
Child C was born at 30 weeks weighing 800g.
Below is the inclusion criteria for transferring a baby from a level 2 to a level 3 NICU.
As can be seen, child C would have not been eligible for transfer.


-Singletons below 27+0 weeks,

-Multiples below 28+0 (where possible transfers should occur In-utero)

- Birth weight below 800g (in-utero transfer where birth weight is anticipated to be below
800g)

- Neonates over 27 weeks who receive ventilation for more than 48 hours and/or whose
condition is deteriorating (those who are unwell and likely to require ventilation for more
than 48 hours should be transferred on day 1).

-Ventilated babies whose clinical condition is
stable and/or improving after 48 hours should be discussed on a daily basis with the relevant
tertiary centre.

-Neonates who require ongoing therapeutic hypothermia. Active cooling, where appropriate
to be initiated within the local unit.

- Neonates requiring complex specialist care e.g. nitric oxide / HFOV, prostaglandin infusion
 
Dr Evans specifically says in relation to baby c and infection being a cause that if additional evidence emerges, he will take that into account. Myers pointed out that dr evans hadn’t received any new evidence on baby c’s infection since that report.
RSBM for focus

"Dr Evans: "You can't exclude infection from [Child C]'s general status.
"He's got an infection, but it's under control."
Mr Myers refers to another of Dr Evans's reports, from 2019, referring to infection being 'probable' as a significant cause in Child C's collapse.
Dr Evans says if he receives additional evidence, then he will change his mind.
Mr Myers says Dr Evans has not received any new evidence on Child C's infection since."

I do bear in mind that we don't have every word exchanged between them, but IMO, Myers says in 2019 Dr Evans said infection was a significant cause, which suggests he didn't think that before 2019. Dr Marnerides agreed with the pathologist in 2019, but changed his mind after also.

Just as Dr Bohin also said his infection played a role in resuscitation, but not as a cause of the collapse -

"Dr Bohin said pneumonia would be a factor in the difficulties in response to resuscitation."

Recap: Lucy Letby trial, Tuesday, November 1

MOO
 
Thanks for bringing those threads together, on the point made by Myers.
"We say, for a starting point, he should have been at a unit providing more specialist care."
Child C was born at 30 weeks weighing 800g.
Below is the inclusion criteria for transferring a baby from a level 2 to a level 3 NICU.
As can be seen, child C would have not been eligible for transfer.


-Singletons below 27+0 weeks,

-Multiples below 28+0 (where possible transfers should occur In-utero)

- Birth weight below 800g (in-utero transfer where birth weight is anticipated to be below
800g)

- Neonates over 27 weeks who receive ventilation for more than 48 hours and/or whose
condition is deteriorating (those who are unwell and likely to require ventilation for more
than 48 hours should be transferred on day 1).

-Ventilated babies whose clinical condition is
stable and/or improving after 48 hours should be discussed on a daily basis with the relevant
tertiary centre.

-Neonates who require ongoing therapeutic hypothermia. Active cooling, where appropriate
to be initiated within the local unit.

- Neonates requiring complex specialist care e.g. nitric oxide / HFOV, prostaglandin infusion

Mr Myers asks about Child C being 'on the limit' with birth weight.
He asks whether it would be "almost inevitable" Child C would have faced complications, and asks if in hindsight, Child C should have been cared for at a tertiary unit.
Dr Gibbs: "That depends on what causes sudden and unexpected collapses [leading to his death]."
Mr Myers asks, taking that aside, should Child C have been cared for at a tertiary centre.
Dr Gibbs: "No."

Recap: Lucy Letby trial, Tuesday, November 1
 
You seem very knowledge about the baby’s condition. I have a question, but of course you are under no obligation to answer it!

I read in one of the previous articles posted that the baby had 15 cc’s of blood aspirated from the stomach around this time. Was it ever determined exactly where the blood came from? In an adult it could be due to a ruptured stomach or esophageal ulcer. Did the post-mortem exam show the source of the bleeding?

I worked in a NICU in the US for 20 years ( though granted this was 15 years ago!) and do not recall ever seeing a baby bleed out like that from the upper GI system. There doesn’t seem any indication the baby was in DIC (disseminated intravascular coagulation) or had any other clotting abnormality.

Curious what your thoughts are.

I think that this was the only baby who did not have a PM, unfortunately.
I agree, you just do not see GI bleeding like this on NNUs.
 
I do think that those who are supporting her are reading online material and potentially feeding back ideas of public opinion. Which is why it was annoying that some members of the public spent the duration of the prosecution, presenting 'new ideas' of what the unheard defenses evidence might be and why it's important that we don't 'pr empt' explanations for the defence, whilst they are still giving evidence. Jmo
^ I wondered about that. My feeling is that surely it wouldn't be allowed?

You can't (thankfully) police people from accessing the internet so the only way visitors could be prevented from passing on online theories and opinions would be for restrictions to be imposed on them - eg. not to discuss anything they've read online that might 'influence' the defendant - while a trial is underway and most specifically when the defendant has taken the stand.

How would they do that? I suppose by listening in on visits since how else could they monitor what's being said - although that sounds unlikely/a breach of a person's human rights to me. I don't know.

I did a google re this but failed to find anything pertinently useful. Learned a lot about prison life though!

Maybe there's a legal eagle on here who might be able to throw some light on things.
 
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I suppose the only way to enforce it would be in the way mentioned, supervised visits. I wonder if that is accommodated.
So interesting the things you learn incidentally when chasing up details on this case.
Last night I watched a documentary of Hmp Styals on you tube. Was a real eye opener.
Apparantly 23 hour lock up for prisoners like letby as they can't integrate with the rest of the prison.
 
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