Lucy Letby failed her final year student nurse placement because she was “cold” and lacking empathy with patients and families, a public inquiry has heard.

Her assessor, Nicola Lightfoot, told how she felt Letby did not have the “overall characteristics” to become a successful nurse.

The Thirlwall Inquiry heard Letby later passed a retrieval placement after requesting a new assessor, claiming she felt “intimidated” by Ms Lightfoot.

She went on to murder seven babies and attempt to kill a further seven on the Countess of Chester Hospital’s neonatal unit between June 2015 and June 2016.

Ms Lightfoot, deputy ward manager on the hospital’s children’s unit, told the inquiry, which is examining how Letby was able to commit her crimes, she found the nurse to be “cold”.

“I did not find a natural warmth exuding from her which I expect from a children’s nurse,” she said.

In her final report on the then University of Chester student in July 2011, Ms Lightfoot wrote: “At the moment Lucy requires much more support, prompting and supervision than I would expect at this stage to allow her to qualify as a competent practitioner.”

She said she found that Letby’s clinical knowledge was “not where it should be”, and that she “struggled” to retain information on medication dosages and to recognise side effects of common drugs.

Any student who failed their final placement had the opportunity to repeat it and achieve the competencies they had not achieved in a four week retrieval, the inquiry heard.

Ms Lightfoot said at the time she believed Letby would not have been in a position to be signed off within four weeks, so “could not objectively continue” as her mentor.

Letby’s next mentor, Sarah Jane Murphy, said she was “conflicted” about passing the student nurse in light of Ms Lightfoot’s comments but said she had met the standards required after the retrieval placement.

Describing Letby as “quiet and shy”, she said: “She didn’t show good interpersonal skills with children, parents, nurses or the wider team.”

She added that Letby “often had quite an expressionless look” which some staff “found awkward”.

Ms Lightfoot also told the hearing she overheard an “inappropriate” comment from Letby in the wake of the deaths of two triplets in June 2016 – who Letby was convicted of murdering.

She said she overheard her telling a colleague: “You’ll never guess what’s happened.”

Ms Lightfoot said: “The way she said it seemed like she was talking about some sort of exciting event she had witnessed.

“It wasn’t an appropriate response to the death of a child.

“I have never, and I have never since, seen a response like that to a nurse involved in a patient’s passing.”

The inquiry continues.

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