A string of deaths of elderly couples in 'murder-suicides' has led to fears a serial killer could be at large in England's north west.

A coroner's concerns over two deaths of couples butchered in their beds in scenes bearing chillingly similarities has prompted a full investigation decades on.

The grisly deaths of two couples in Wilmslow, Cheshire are now being looked at as potential murders - and flags have been raised in other brutal deaths of elderly couples around the region in the decades since, according to a special investigation by the Sunday Times investigative team Insight.

The 1996 deaths of Howard and Bea Ainsworth in Wilmslow, was followed by another apparent separate murder-suicide - Donald and Auriel Ward.

Both the Ainsworths and the Wards were described as devoted couples, whose deaths blamed at the time on murder-suicides carried out by the husbands, stunning their families.

In both cases, the couples were found lying in their bloodstained bed in their pyjamas - and involved horrific levels of violence.

Donald and Auriel Ward died in an apparent murder-suicide in 1996

And in both cases, there was no history of domestic violence known to the police, the couples' friends or families.

The Sunday Times reports that serious questions have been raised about the deaths - and whether they could actually have been double murders.

Some experts looking at the cases have even raised concerns they could be the handiwork of one sadistic serial killer.

Three other murder suicides have also been identified involving elderly couples in north west England for authorities to review in light of the stunning revelations.

Howard and Bea Ainsworth died in 1996 in Wilmslow, Cheshire

Two deaths of couples in Greater Manchester and one of a couple in Cumbria has seen some raise the possibility that at least some of the deaths - if not all - could be work of a serial killer who has never been caught.

In the case of the Ainsworths, 78-year-old Bea was found in bed in her nightie on the bed with a knife in her forehead.

She had been struck about the head several times with a hammer, and she was found with a pillow partially over her face.

Husband Howard, 79, lay beside her in his pajamas with his head hooded with a bag.

Police investigated and found a suicide note seemingly written by Howard, and declared the deaths a murder-suicide.

Stanley, 92, and Peggie Wilson, 89, were found dead in their Kendal, Cumbria home in February 2011

Three years later the Wards were found dead in an eerily similar scene.

Auriel had been bludgeoned to death, stabbed and suffocated and her head was found partially covered by a pillow.

Her husband Donald was found next to her with a knife stuck into his heart.

Police investigated the deaths and found Donald’s mind must have been disturbed and that he had taken his own life after killing his wife.

In both cases, the women's bodies were reportedly found with their nighties hitched above hip-height.

Coroner's officer for Cheshire, Christine Hurst, was reportedly so troubled by the similarities in the cases, she earmarked them in a special file- that went largely undisturbed for two decades.

In a written statement, she later reportedly said the cases just didn't seem "right" and she had been "appalled at the level of violence" and struck by the similarities in the victims' demise and body positioning.

When she retired in 2017, she reportedly passed the cases of concern to her successor Stephanie Davies.

According to the newspaper, Stephanie Davies compiled a 179-page report exploring the circumstances of the five murder-suicides.

The report, put together by Davies, the chief coroner’s officer for Cheshire Police, echoed her predecessor's fears that the cases had striking parallels - and raised the alarm there could be more.

She narrowed down the cases to the type of injuries suffered by the couples in Wilmslow and identified three more apparently similar cases across Manchester and one in Cumbria.

The Sunday Times says Davies makes clear in the report she cannot be sure those three cases are linked until their police files have been reviewed, and acknowledged crime scene investigation techniques had advance significantly since the deaths.

Michael, 59, and Violet Higgins, 76, died in Didsbury in February 2000

Two of the cases deemed murder suicides and fitted the pattern in Greater Manchester, and were within half an hour's drive from the Wilmslow deaths.

According to the newspaper, in each case the elderly woman had been stabbed in the neck and suffered “blunt force trauma” to their heads.

In each case, the women had been deemed by authorities to have been attacked by their husbands, who had then taken their own lives.

Violet Higgins, 76, an ex-policewomen, was found dead alongside her husband Michael, 59, in Didsbury, Manchester in 2000

Michael had Parkinson’s disease and his wife was reportedly considering putting him in a home, but family reportedly described him as incapable of violence.

She was found in her nightie in the couple’s bed while Michael was discovered in his pyjamas in the spare room.

Violet had been beaten over the head with a rolling pin and stabbed in the neck with scissors, and Michael had cuts to his hands and was found strangled in a coat hanger.

Kenneth, 77, and Eileen Martin, 76 were found dead in their Davyhulme, Greater Manchester garage, in 2008, just ahead of their 55th wedding anniversary.

Eileen had dementia and their said they could not comprehend the finding that Kenneth had killed Eileen.

The couple’s bodies were both found in the garage with Eileen having suffered severe head injuries and Kenneth hanged with a cut throat.

Stanley, 92, and Peggie Wilson, 89 were found dead in their Kendal, Cumbria, home in 2011 and were said by friends to have been a loving couple, according to the Times' report.

Kenneth, 77, and Eileen Martin, 76, were found dead in their Davyhulme home in November 2008

But Stanley had begun suffering from mental illness and paranoia and investigators said he must have dealt Peggie the blunt-force injuries to her head and knife wounds to her neck.

Stanley died of cuts to his neck and body, ruled to have been self-inflicted.

Last month, Davies reportedly handed the report to Cheshire police - who confirmed to the Sunday Times they have now launched a review, and alerted the Greater Manchester and Cumbria forces.

The report is raising the alarm of a potential serial killer on the loose, according to the stunning claims.

Davies' report calls on the National Crime Agency and Interpol to carry out an urgent review of cases across Britain and Europe to unearth any potentially similar deaths.

A top “cold case” police forensic investigator agreed with Davies about both the Wilmslow cases - claiming vital clues had been missed in the initial investigations, according to the Sunday Times report.

“I would be looking at the same offender involved in both cases as a very real possibility,” his review of Davies' files reportedly said - although he warned he was not certain.

Nazir Afzal, the former chief prosecutor for the northwest this week told the Sunday Times: "The concerns raised in this report need to be taken very seriously.

"We could potentially have a serial killer in our midst. There needs to be a proper review of these cases and others which carry similar hallmarks."

Cheshire Police told the newspaper it is reviewing the report, and has notified the other forces concerned.