Lucy Letby's former boss, Alison Kelly, tells a public Inquiry she had "good intentions" despite failing to escalate concerns about the nurse
Kelly was director of nursing and lead for safeguarding at the Countess of Chester Hospital when Letby killed seven babies and tried to kill seven others
Kelly is pushed on why more was not done to prevent Letby from working after concerns had been raised about her. She says the idea of a nurse harming babies was "difficult to comprehend"
She is also quizzed about why she spoke to Letby during a grievance process, and why she told the nurse she would be going back to the unit before the investigation was complete
Kelly accepts that as part of the same process, she made "misleading and potentially false" statements in her interview with the doctor who was investigating
Judith Moritz
Special correspondent, reporting from the inquiry
Alison Kelly is now being asked about an inspection which was carried out by the hospital regulator, the Care Quality Commission, in February 2016.
More information about the inspection was heard earlier in the inquiry and can be found in this article.
Judith Moritz
Special correspondent, reporting from the inquiry
The inquiry has just returned after a short break.
One point of note from the earlier evidence: Kelly commented that Lucy Letby’s parents were “very keen” for the hospital executives to refer the consultants to their regulator, the General Medical Council.
Judith Moritz
Special correspondent, reporting from the inquiry
Counsel to the inquiry Nick de la Poer asks Alison Kelly to "consider the possibility that you created the impression that you were somebody to be feared".
Kelly replies: "I’m just very upset by that because it’s not in my nature to provide that impression to staff at all levels, whether they’re a consultant or they’re a healthcare assistant, and through my career I have been held up to be a credible leader, to listen, to support, to take action.
"So to suggest that of me, I think I would disagree and it’s not something that is in me as a nurse, as a senior leader, and for somebody to gain that impression of me is very upsetting."
Nick de la Poer continues: "Do you think it’s possible that things had become so acrimonious - doctors versus nurses - with you backing the nurses - that a culture of fear had developed?
Kelly replies: "I wouldn’t say a culture of fear. I think there were challenges with the relationships. I think that trust had broken down. "On reflection we could have done more to support the clinicians but it was a really challenging time. We were dealing with multiple reviews, understanding what on earth was going on, listening to both sides. We listened to everybody and took their perspectives.
"I would not say that it was a culture of fear at all - there was lots of engagement - it was just tense at times which is why we gained advice from external agencies and the police eventually."
Judith Moritz
Special correspondent, reporting from the inquiry
A community paediatrician, Dr Howie Isaacs has previously told the Thirlwall Inquiry that, although she was one of the safeguarding leads within the hospital, she was afraid of going to speak to Kelly because “there was a culture of fear” within the hospital.
Asked about it, Kelly says: “I heard that evidence, and I was really upset and disappointed by that response, because she was a safeguarding lead.
"I had a very open door policy, as an executive and a safeguarding lead. Nobody else has ever come to me to say they feared coming to raise any concerns with me."
She adds that for Dr Isaacs to "suddenly say that she felt afraid of coming to speak to me" was "very out the blue, very sad to hear".
Judith Moritz
Special correspondent, reporting from the inquiry
The consultants’ concerns were eventually logged under the Speak Out Safely scheme in June 2016.
Nicholas de la Poer asks Alison Kelly if this was an attempt to “rewrite the past” now that the police were involved.
She says “no. Not at all".
Judith Moritz
Special Correspondent, reporting from the inquiry
In early 2017, after Letby’s grievance process was upheld (in response to the concerns raised against her), the consultants were told to apologise to her.
The inquiry has just been shown a letter which the hospital’s medical director Ian Harvey sent to the doctors, telling them to enter mediation with Letby “as a potential way to avoid a referral to the General Medical Council”.
The consultants did not have the protection of the formal 'Speak out Safely' whistleblowing process at the time, because it had not been activated.
The counsel to the inquiry says to Kelly: “All this pressure was coming down on the consultants about possible referral to their regulator. I would just like you to reflect on whether there was any connection between that, and the decision of the committee you sat on not to formally record their concerns?”
Kelly denies this, saying she thinks the failure to record the consultants’ concerns about Letby under this protective whistleblowing process “fell by the wayside”.
Judith Moritz
Special correspondent, reporting from the inquiry
Image source, Thirwall InquiryAt a meeting in January 2017, the hospital’s chief executive, Tony Chambers, told the paediatric consultants that their concerns were “being professionally managed” under the Speak Out Safely scheme.
Alison Kelly was at this meeting and knew this wasn’t true but didn’t correct him.
Counsel to the inquiry De la Poer asks: “That was a false statement wasn’t it?”
Kelly replies: “I think that because it had been talked about so many times there was an impression that it was being dealt with under the Speak Out Safely policy.”
Judith Moritz
Special correspondent, reporting from the inquiry
Kelly is asked about a scheme called ‘Speak Out Safely’, which was a formalised whistleblowing process within the NHS in 2016.
She says: “The Speak Out Safely processes weren’t fully embedded in the organisation [the Countess of Chester Hospital] at the time."
Kelly says she accepts that “on reflection” consultants’ concerns should have been logged under that whistleblowing scheme.
"I think we were a little bit bewildered at some of the things that were being said, and it took a while to get that straight in our minds really to get actions underway. And there was so much going on in a short space of time," she says.
Counsel to the inquiry De la Poer puts it to her that it's important for a person raising concerns that the policy is properly managed and that it gives people reassurance that they will be protected, and Kelly agrees.
It's put to her that the process ensures people "don't get silenced".
"Yes," Kelly says.
Judith Moritz
Special correspondent, reporting from the inquiry
Image source, Thirwall InquiryAlison Kelly accepts that when she made a referral about Lucy Letby to the local safeguarding board in March 2018, it wasn’t detailed enough.
"Is it because you had a feeling of hostility towards the consultants and you didn’t think the police investigation was going anywhere?" Counsel to the inquiry De la Poer asks.
Kelly replies "that’s not true".
De la Poer asks in relation to the safeguarding referral of March 2018: "Do you think this is a misleading and highly defensiive document?"
Kelly replied: "I would not say it’s defensive or misleading, I think it lacks detail and on reflection I should have put more detail in there."
Judith Moritz
Special correspondent, reporting from the inquiry
Questioned about these concerns, Kelly says: "I didn’t take the hearsay of consultants as evidence at that time."
Counsel to the inquiry De la Poer says: "It may not be proof but it is information which suggests that they may be telling the truth isn’t it?"
Kelly replies: "Information to suggest that, yes."
De la Poer asks if that is just another name for evidence, and Kelly responds saying: "At the time I didn’t take that as evidence."
Judith Moritz
Special correspondent, reporting from the inquiry
Alison Kelly has accepted that concerns about Lucy Letby were first raised with her in March 2016.
Judith Moritz
Special correspondent, reporting from the inquiry
Kelly explains that she did not make a safeguarding referral about Lucy Letby earlier than 2018 because “we were trying to balance what we were actioning within the organisation versus thinking of the welfare of an individual”.
The individual whose welfare she is referring to appears to be Letby herself.
Judith Moritz
Special correspondent, reporting from the inquiry
Alison Kelly is asked why she didn’t inform NHS England in July 2016 about the concerns of consultants that a nurse was causing deliberate harm to babies. She answers that the decision not to do so was ‘a really fine balance.
De la Poer asks: "Where is the balance in saying we are giving active consideration to, amongst other things, whether deliberate harm has been caused, which was the truth?"
Kelly replies: "Yes I could have said that."
De la Poer asks again: "Why didn’t you?"
Kelly says: "I don’t know."
De la Poer follows up: "Were you trying to withhold that information deliberately?"
Kelly replies: "No, as I have said, on reflection there were actions that didn’t get right but the actions I did take were done with good intentions."
Judith Moritz
Special correspondent, reporting from the inquiry
Kelly says she accepts that, looking back, there was a safeguarding issue and she didn’t treat it as such.
“But neither did anybody else. I take my duties very, very seriously," she says, adding: "I was still relying on the teams from the unit upwards to bring any safeguarding concerns to me and nobody did."
The counsel to the inquiry puts it to Kelly that at the time consultants thought Letby was murdering babies: "That was their central message to you."
Kelly responds: "In June they talked about deliberate harm, yes."
The counsel to the inquiry asks: "And deliberate harm to a human that is now dead is murder, isn't it?"
"Yes," Kelly says.
Judith Moritz
Special correspondent, reporting from the inquiry
Alison Kelly was the executive lead for safeguarding at the time. She has accepted that when concerns about the rise in mortality on the neonatal unit were brought to her in May and June 2016, “it just didn’t feel like a safeguarding concern to me”.
She says that the consultants who brought their concerns to her didn’t articulate what their concerns were.
Kelly continues: “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."
Judith Moritz
Special correspondent, reporting from the inquiry
Image source, Thirwall InquiryThe questioning continues.
De la Poer asks Kelly: "So he [Dr Brearey] was raising the possibility that Letby may be deliberately harming babies, is that right?"
Kelly replies: "I would push back on that and say there was never any clarity in him articulating his true concerns at that time."
De la Poer continues: "It must be the case that what he was saying is that Letby may have been deliberately harming babies?"
Kelly: "Maybe, yes."
De la Poer: "And so as to the issue of inadvertent or incompetent harm you had very strong reassurances didn’t you from (nursing bosses) that incompetence was unlikely."
Kelly: "Yes."
Judith Moritz
Special correspondent, reporting from the inquiry
Image source, Thirwall InquiryKelly is asked about a meeting she had with lead neonatal consultant Dr Stephen Brearey in May 2016.
It's put to Kelly that Dr Brearey raised his concern that Letby may be the cause of the rise in mortality on the neonatal unit
Kelly says the doctor never talked about deliberate harm but he was worried about the increase in mortality.
The counsel asks that if the rise in mortality was linked to Letby, if Kelly agrees there were only two possibilities - one to do with Letby being incompetent, the other being deliberate harm.
Kelly says she agrees.
The counsel to the inquiry asks if the doctor raised the possibility that Letby may have been deliberately harming babies.
Kelly says she would "push back" on that, saying there was never any clarity in him articulating his true concerns at that time.
Judith Moritz
Special correspondent, reporting from the inquiry
Alison Kelly has asked if she can say something before the formalities get underway.
She says: “I would like to express my condolences to all the families and I’m really sorry for all the distress they’ve experienced over the last few years and are currently experiencing as we sit here today.
"I didn’t get everything right at the time, however the decisions I made were done with the best intentions.
"I do really appreciate having the opportunity to be part of this inquiry and share my reflections and to contribute to recommendations going forwards.”
Alison Kelly arriving at the inquiry this morning
The inquiry is now hearing from Alison Kelly, who was director of nursing at the Countess of Chester Hospital and Letby's former manager.
She has been accused, along with other hospital managers, of ignoring warnings about Letby.
She was suspended from her position with the Rochdale Care Organisation last year "in light of information" which emerged during the trial and following the announcement of the inquiry, NHS England said at the time.
She has more than 30 years of experience as a nurse and was director of nursing and quality at the Countess of Chester Hospital for eight years before starting her current role, the Northern Care Alliance NHS Foundation Trust's website says.
Alison Kelly, former director of Nursing at the Countess of Chester Hospital at the time of Lucy Letby’s crimes, has begun giving evidence and today's hearing is underway.
She is being questioned by Counsel to the Inquiry, Nicholas de la Poer KC.