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Senior managers at the hospital where Lucy Letby murdered seven babies and attempted to kill a further seven have apologised for the “significant delay” in alerting police to concerns over the now-convicted nurse.
The former bosses at the Countess of Chester Hospital also accepted communication with the bereaved families could have been better.
On the fifth day of the Thirlwall Inquiry, which is looking at the circumstances around the 34-year-old’s offences, Kate Blackwell KC introduced and read parts of a statement issued on behalf of four of the senior bosses.
They are former medical director Ian Harvey, former director of nursing Alison Kelly, former chief executive Tony Chambers and former director of people and organisational development Susan Hodkinson.
Their statement revealed how they first became aware of colleagues’ concerns over Letby at the end of June 2016 - but due to a lack of evidence from their own inquiries, Cheshire Police were not informed until May 2017.
Initial inquiries did not prove anything beyond Letby being on shift at the same time of the deaths, with neo-natal unit manager Eirian Powell judging the killer as being a “good and competent nurse”, senior managers said.
However, Letby was removed from duties on the ward from 30 June 2016 as a precaution - and she would never return to the same role.
Speaking to the inquiry on Friday morning, Ms Blackwell said the hospital bosses felt they needed to investigate the matter to gain potential evidence of wrongdoing before contacting Cheshire Police.
Ms Blackwell said: “This was a cause of a significant delay in contacting the police and for this, they [the managers] are truly sorry.
“But the reviews were commissioned in good faith, not to conceal the truth but to uncover it... on the issue of when such matters should be properly brought to the police in a hospital setting, guidance is overdue and such recommendations as the inquiry sees fit will be well appreciated.”
Ms Blackwell also addressed concerns from the families over a lack of communication, which was raised on Thursday by a solicitor representing seven groups of relatives after it earlier emerged in the inquiry that they were never aware of a link to a particular nurse.
Peter Skelton KC said some families were “kept in the dark” over the collapses of babies and the concerns, and investigations that were being undertaken.
Ms Blackwell told Friday’s inquiry: “[The issue of communication] has caused hurt and anxiety - and for this, the senior managers are deeply sorry.
“This was not done with the intention to deliberately attempt to cause anguish, nor was it to involve a conspiracy of dishonesty. At the time they believed they were providing the right level of information, they wanted to make sure that what they were saying was accurate.
“In hindsight, they could and should communicated far better than they did.”
A written statement on behalf of the four senior managers showed how the first suspicions over Letby were handled, with bosses initially becoming aware of concerns following the deaths of two babies on 23 and 24 June 2016.
The increase in deaths on the neo-natal unit was also already under the radar of Mr Harvey and Ms Kelly.
But a review found some of the deaths involved very sick babies that may have contributed to the number, the managers said in a statement.
A further meeting on the issue in July 2016 highlighted Letby had been on shift when a number of the deaths occurred, but because she was a specialist practitioner she was “more likely to be looking after the sickest infants”, the managers said in their statement.
Her bosses also raised no performance issues with her, and she was judged as being a “diligent nurse with excellent standards”.
Despite further concerns raised by colleagues in September 2016, the senior managers said a visiting review team from the Royal College of Paediatrics and Child Health also did not raise concerns over Letby’s involvement in the deaths.
However, as revealed earlier in the inquiry, some members of the team claimed they were not alerted to the nurse before their arrival. They were also told by Mr Harvey that junior doctors had nicknamed Letby “Nurse Death”.
In March 2017 the police had still not been alerted, with the hospital trust seeking legal advice on approaching the police.
“In hindsight, whilst done with the best intentions, this was unhelpful and led to a delay,” the hospital bosses said in their statement to the inquiry.
The inquiry further heard from a legal representative at the Care Quality Commission, which carried out a routine inspection at the hospital including the neo-natal unit, in February and March 2016.
Jenni Richards KC, speaking on behalf of the CQC, said it was only told about concerns over Letby by the hospital following the publication of the report, and then on suspicions of criminal activity after police had been told.
An opening statement was also provided to the inquiry on behalf of NHS England on Friday morning. Jason Beer KC, who represented the body, said it took too long for the hospital to contact Cheshire Police.
The inquiry continues on Monday.
