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‘I would examine the body carefully to ensure death had occurred,’ he said. ‘If I found no pulse at the neck, I would look for a more central point.’

Grenville also pointed out that Shipman made no attempt to revive the patient, which would have been standard medical practice.

As the details of each case were presented, other patterns emerged. Shipman told bystanders that he had called 999, but when he checked and found the patient dead, he would pick up the phone and pretend to cancel the ambulance – though none was on its way.

This occurred in the case of Lizzie Adams who was murdered on 28 February 1997. Although she was 77 year old, she still loved dancing. Her dance partner William Catlow dropped in at Mrs Adams’ Coronation Street home the day she died to find Shipman inspecting her magnificent collection of crystal and porcelains. In the next room, Lizzie lay dying.

‘I just burst past him,’ Catlow told the court. ‘She felt warm. I said: “I can feel her pulse.”’

According to Catlow, Shipman said: ‘No, that’s yours. I will cancel the ambulance.’

But telephone records showed that Shipman had not phoned for an ambulance that day. He later persuaded the family to have her body cremated.

Shipman also claimed to have called an ambulance when he killed 64-year-old Norah Nuttall on 26 January 1998. Her son Anthony said he had left his mother alone for just 20 minutes, returning to find Dr Shipman leaving the house.

‘I asked him what was wrong,’ said Anthony. ‘He said: “I have rung an ambulance for her.” I ran in and she looked like she was asleep in the chair. I took her by the hands and shook her, saying, “Mum, Mum.”’

Then Shipman touched her neck and told the son: ‘I’m sorry, she has gone.’

Naturally, the family did not find this at all satisfactory and Norah Nuttall’s sister went to Shipman’s office to examine the dead woman’s records because she wanted more details of her sister’s death. Annoyed, Shipman told his staff: ‘I knew it would happen, I told you it would happen.’

He quickly made up a story of how Norah had phoned his office to say she was ill. Later he claimed he had been paged and, as he happened to be nearby, he made a house call. The telephone records proved that both of these stories were fabrications.

Shipman was caught in another lie. He had said that his reason for visiting Kathleen Grundy was to collect blood samples for a study on ageing. When he was asked what had happened to them, he said they had been sent for analysis. But the prosecution demonstrated that Shipman was not involved in any study on ageing. When confronted, Shipman then remembered that he had left the samples under a heap of notes and, once they were no longer useful, he thrown them away. This did little to bolster his credibility.

The court was also struck by Shipman’s lack of compassion toward the bereaved. Lorry driver Albert Lilley broke down as he told of the way Shipman announced the death of his wife, 58-year-old Jean Lilley, after he had killed her on 25 April 1997.

‘He said: “I have been with your wife for quite a while now, trying to persuade her to go to the hospital, but she won’t go. I was going to come and have a word with you and your wife, and I was too late,”’ Lilley testified. ‘I said: “What do you mean too late?” He said: ‘You are not listening to me carefully.”’

It seemed Shipman actually took pleasure in forcing Lilley to guess his wife had died. Shipman played a similar guessing game with Winnifred Mellor’s daughter Kathleen.

‘He said: “Did you realise that your mother has been suffering from chest pains?” and I said: “No”,’ Kathleen told the court. ‘He said: “She called this morning and I came to see her and she refused treatment.” So I said well I’ll be up as soon as I can. He said: “No, no there’s no need for that. So I said has she gone to hospital?” And he said: “There’s no point in sending her to hospital.” And I just went silent then, and he didn’t say anything neither. And