I had good intentions - Letby safeguarding boss

Alison Kelly was asked why she had not considered concerns raised by doctors about Lucy Letby as a safeguarding matter

The head of safeguarding at the hospital where Lucy Letby killed babies has told a public inquiry she had "good intentions", despite failing to escalate concerns about the nurse.

Alison Kelly was director of nursing and executive lead for safeguarding at the Countess of Chester Hospital when Letby murdered seven infants and tried to kill seven others.

Senior consultant Dr Stephen Brearey told Ms Kelly in May 2016 that there were concerns about Letby's links to unexplained deaths on the unit, the inquiry heard.

However Ms Kelly said at the time she "just didn't see it as a safeguarding concern".

The Thirlwall Inquiry, which is examining how Letby was able to commit her crimes, heard Ms Kelly did not submit a safeguarding referral to the local safeguarding board until March 2018.

Giving evidence at Liverpool Town Hall on Monday, Ms Kelly said: "There was no articulation of the actual issues, nobody had seen her do anything.

"There was terms used like 'gut feeling' and 'drawer of doom' which didn't pinpoint any issues to do with Letby, so on the basis of that, I didn’t have any facts or evidence that I could base my decisions on."

Concerns about Lucy Letby (pictured) did not reach the police until 2017

Barrister Nicholas de la Poer KC, counsel to the inquiry, asked why Ms Kelly did not report the concerns raised by doctors to NHS England in July 2016.

She said the decision not to do so "was a really fine balance" and she saw the concerns reported by doctors as "hearsay".

However she accepted that, looking back, it was a safeguarding issue and she should have responded accordingly.

"But neither did anybody else," Ms Kelly pointed out.

"I take my duties very, very seriously... but I was still relying on the teams from the unit upwards to bring any safeguarding concerns to me and nobody did."

'Not detailed enough'

Mr de la Poer asked her if she was "deliberately" trying to "withhold" information about someone possibly harming babies.

Ms Kelly replied: "No, as I have said, on reflection there were actions that I didn’t get right but the actions I did take were done with good intentions."

The inquiry heard Ms Kelly's safeguarding referral came in March 2018, almost a year after Cheshire Police was first called to investigate unexplained deaths and collapses on the unit.

Ms Kelly accepted the referral was "not detailed enough".

Mr de la Poer asked: "Is it because you had a feeling of hostility towards the consultants and you didn’t think the police investigation was going anywhere?"

Ms Kelly said: "That's not true."

Mr de la Poer also suggested things had become "acrimonious" between doctors and nurses and that a "culture of fear" had developed.

"I would not say a culture of fear," Ms Kelly said.

"I think there were challenges with the relationships, I think the trust had broken down and I think on reflection we could have done more to support the clinicians, certainly in a pastoral perspective."

Dr Stephen Brearey (pictured) said he had mentioned Lucy Letby to director of nursing Alison Kelly in 2015, which she denied

She agreed that while it was "not unheard of" for a nurse to deliberately harm patients, it had not been "in the forefront of my mind".

Ms Kelly went on: "I think at the time I was relying on my senior nursing team to give me assurances on Letby, particularly Eirian Powell (unit ward manager) who knew her best.

"I would not know individual nurses on an individual basis."

She said the consultants were still not expressing clearly why they thought Letby was harming babies, which she found "quite frustrating".

Last week at the public inquiry, Dr Brearey recalled saying "oh no, not Lucy, not nice Lucy" at a meeting with Ms Kelly in July 2015.

This followed the discovery Letby had been present for the deaths of three infants weeks earlier.

Ms Kelly denied this account of events.

"That was not said at the meeting," she told the inquiry on Monday.

"Lucy Letby’s name was not mentioned at all."

Ms Kelly told her barrister, Kate Blackwell KC, that she did not hear from Dr Brearey again until May 2016 when he told her a nurse had been moved to day shifts after being linked to a number of incidents.

Ms Kelly said the executive team were "constantly asking questions" of the clinicians about evidence and had requested more information.

She said she learned in March 2017 that consultant Dr Ravi Jayaram had witnessed an incident in February 2016 in which Letby had been beside the cot of a baby girl known as Child K.

She told the inquiry: "We were shocked that we had not been told that before."

Ms Kelly started her evidence by expressing her condolences to all of the families affected by Letby's crimes.

Letby, then 34, was convicted of murdering seven babies and attempting to murder seven others, including two attempts on one infant, between June 2015 and June 2016.

She is serving 15 whole life sentences.

The public inquiry is now in its 11th week and is expected to sit until early 2025.