After Lucy Letby was convicted of killing seven babies and attempting to murder seven others, the government set up this independent public inquiry.

Its purpose is to examine the circumstances surrounding serial killer Letby's crimes, including the events that took place at the Countess of Chester hospital, where she worked. It is being overseen by Lady Justice Thirlwall.

The key objectives are to seek answers for victims’ families and to make sure lessons are learned.

It will also look at the wider circumstances, such as response and conduct of the NHS.

Whilst an inquiry is not a legal body, the findings can suggest recommendations to be put in place. Beginning in September, it’s expected to continue until the end of the year at least.

Image source, Chesire Constabulary

This is an exceptionally complex case. Here are the key elements of it:

• Lucy Letby was convicted in two separate trials of murdering seven babies and attempting to kill seven others at the Countess of Chester Hospital between June 2015 and June 2016
• At the end of her first trial, Letby was sentenced to 14 whole-life terms. She was given a fifteenth whole life order in July following a retrial for the attempted murder of Baby K
• The trial ran from October 2022 to August 2023, and the retrial was ordered after a jury was unable to reach a verdict on one count of attempted murder of a baby girl
• The retrial found her guilty of the attacking a new-born infant during a February 2016 night shift at the Countess of Chester hospital
• Letby deliberately injected babies with air, force fed others milk and poisoned two of the infants with insulin
• Dr Stephen Brearey first raised concerns about Letby in October 2015. He said no action was taken and she went on to harm five more babies
• Operation Hummingbird was launched in 2017 by Cheshire Police, and Letby was first arrested at her home in Chester in July 2018
• Two separate applications from Letby toappeal against her convictions have been denied

As a reminder, the Thirlwall Inquiry is not a criminal inquiry – it cannot determine criminal or civil liability, but can highlight where failings have occurred.

Image source, Cheshire Constabulary

Former nurse Lucy Letby is currently in jail, after being found guilty of murdering seven babies and attempting to murder a further seven.

The 34-year-old carried out her crimes at the Countess of Chester Hospital between June 2015 and June 2016.

Letby deliberately injected babies with air, force fed others milk and poisoned two of the infants with insulin.

She is the most prolific child serial killer in modern British history, and will spend the rest of her life behind bars.

Her conviction prompted this inquiry, so the circumstances around her crimes could be examined.

• Courtroom drama, a failed appeal, and battles over the truth

Tony Chambers, who will continue giving evidence today, was the chief executive of the Countess of Chester Hospital when Lucy Letby worked there and carried out the murders.

Doctors at the hospital felt their concerns had been ignored by senior hospital bosses at the trust - while Chambers was in the role.

Many have already told the inquiry of instances where they felt their worries were brushed under the rug, and opportunities to report Letby were missed.

Chambers resigned in 2018, after police launched an investigation into the deaths.

He went on to get three senior NHS jobs following the nurse's arrest for murdering babies.

He previously told the BBC: “As chief executive, my focus was on the safety of the baby unit and the wellbeing of patients and staff. I was open and inclusive as I responded to information and guidance.”

Good morning and welcome back to our live coverage of the Thirlwall Inquiry, which is examining the Countess of Chester Hospital's handling of the Lucy Letby case.

Yesterday the inquiry heard from the hospital's former chief executive, Tony Chambers, and he'll continue his evidence this morning.

He told the inquiry he was "truly sorry" for the "pain that may have been prolonged by any decisions or action that I took in good faith".

You can scroll down this page for a more comprehensive summary of what he said.

Later today, we'll also hear from Ian Harvey, the hospital's former medical director.

Our correspondent Judith Moritz will be at the inquiry in Liverpool bringing you the latest lines.

We're closing today's coverage of the Thirlwall Inquiry, which is looking at how the Countess of Chester Hospital dealt with the Lucy Letby case.

Since 10:00 GMT, the hospital's former chief executive, Tony Chambers, has faced a series of questions from lawyers. Here's a recap of some of his evidence:

• Chambers began by saying he was "truly sorry" for the "pain that may have been prolonged by any decisions or actions that I took in good faith"
• He said he first learned of doctors' concerns on 29 June 2016, five days after the death of the last baby Letby murdered
• He said the concerns about Letby were "very shocking" to hear, but that "we wouldn't jump to criminality as the causal factor"
• On 27 March 2017, a consultant told Chambers that police should be involved. Chambers agreed, but after consulting a criminal lawyer, Chambers only informed police - via a letter to the chief constable - on 2 May. The first meeting with police was 5 May
• The inquiry heard that Letby was taken off duty in the neonatal unit in 2016, but was told at a December 2016 meeting that she would be allowed back
• At the meeting, Chambers said Letby's father was "very angry [at her treatment]. He was making threats... threatened guns to my head"
• Chambers also accepted that, at this meeting, he said "for your resilience Lucy, you astound me"
• At a meeting in February 2017, Letby - who murdered seven babies in 2015 and 2016 - said she expected "four apologies" from doctors who raised concerns about her
• During that meeting, Chambers said: "Lucy, don't worry. We've got your back" - today, he accepted that language was "clumsy"
• The inquiry heard of tension between hospital executives and senior doctors - and that some doctors were warned of a possible referral to the regulator, the General Medical Council (GMC)

Liz Roberts
Reporting from the inquiry

We're now hearing Skelton KC press Chambers about the details of another baby, referred in the court as Baby A.

He puts to Chambers that it does not appear that the coroner was informed that there were suspicions about the child's death. He adds that that is "unacceptable".

Chambers replies that "it’s clearly, in hindsight, absolutely unacceptable".

He adds that what he is "absolutely sure about" is that there would have been "no deliberate" action on their part to not share "openly and honestly with the coroner".

"I’m certain it wouldn’t have been any sort of instruction from the Countess."

That concludes Chambers' remarks for the day and the inquiry will reconvene tomorrow at 10:00 GMT.

Liz Roberts
Reporting from the inquiry

It’s now put to Chambers that there was a group of consultants who didn’t want Lucy Letby back on the hospital unit, but there was an executive team that did.

Chambers says there was a grievance process "and no suggestion of any connection with deliberate harm".

But, he adds, “as soon as new matters became known to us”, the police were called.

Skelton asks specifically what new matters.

Chambers says it was Dr Jayaram's concerns that he raised with HR director Sue Hodkinson about Letby's treatment of Baby K.

• A reminder: Letby was found guilty in July of trying to kill a premature baby girl, referred to in court as Baby K, following a retrial.

Liz Roberts
Reporting from the inquiry

Focusing on Chambers' evidence to the inquiry today, Skelton says it is an "odd feature" that "you don’t seem to fully recognise that the consultants were entirely right about the risks" posed by Lucy Letby.

"When I put it you that in 2017 those concerns that they had had, indeed from 2015, had not been addressed satisfactorily and there was still a risk - that is correct isn’t it? She had in fact killed children?" he says.

"All I can offer you is the evidence of what we believed at the time," Chambers replies.

Liz Roberts
Reporting from the inquiry

Skelton now asks Chambers about an earlier statement to the inquiry from NHS England, which says it was not aware of concerns about potential criminal conduct at the time consultant's were raising their concerns.

Chambers says he believes the information shared with NHS England was "around the increased mortality, not the link to the nurse". That, he thinks, was made "some time in 2017".

Skelton asks if he accepts that the body should have been told about the concerns about Letby.

"I don't know," Chambers says. "It’s just the balance between duty of candour and duty of care. Whether I got that balance wrong I don’t know."

Liz Roberts
Reporting from the inquiry

Chambers continues, saying to Skelton: "when you use emotive language of murder...it becomes not something that I heard at that time."

He then adds: "if you are saying the possibility of harm, then there were discussions."

"There were a range of scenarios to explore."

Skelton asks when he was aware of that possibility.

"I think I felt those issues almost immediately."

Liz Roberts
Reporting from the inquiry

Skelton presses Chambers: "Just to be clear, was it your evidence that you were not aware of the possibility that children may have been deliberately harmed at the end of June?"

"It was much less explicit than that," Chambers says, "if for one moment that’s what I believed, I had heard, and that was being said, the board would have gone straight to the police".

Skelton continues, asking Chambers: "When did you become aware of that possibility?"

Chambers replies by saying, "it was never concretely said in the way that you have said".

He then adds: "There’s so much hindsight inherent within your question. At the time that’s not the information I had or we had."

Liz Roberts
Reporting from the inquiry

Chambers is now being questioned by Peter Skelton KC, who represents a group of families.

"You were aware of the possibility that the babies had been deliberately killed, yes?" Skelton asks.

"I was only aware only of the concerns that were raised", Chambers says, "and the circumstantial link with an individual member of staff".

Liz Roberts
Reporting from the inquiry

Chambers is now being questioned about a potential vote of no confidence in him as the chief executive of the hospital.

He would eventually step down from his role in light of the ongoing police investigation into deaths at the hospital's neonatal unit.

Chambers says he "had a contract" and "had done nothing that was in breach of that" so had contractual right to a minimum six months' notice period.

"All I was wanting from this … if we could have got more that would have been great but as an absolute minimum was the opportunity to work my notice being useful to the NHS in some other organisation," he says.

"I wanted to be able to work my notice in an organisation so that I then had an opportunity to reset and maybe rebuild."

"I wasn’t aware, genuinely wasn’t aware, that there was ever going to be a vote of no confidence. That was something that began to be talked about but I genuinely wasn’t specifically aware of it," he says.

Asked if he left to avoid scrutiny of his leadership he says: "No, I mean there was no suggestion that... there could have been a vote of no confidence."

Liz Roberts
Reporting from the inquiry

Nicholas de la Poer KC now asks Chambers why they were talking about referring two of the doctors from the unit - Dr Stephen Brearey and Dr Ravi Jayaram - to the GMC.

Chambers says "that's not what we were talking about".

"It was saying what are the potential things that we might need to do if there isn’t a police investigation. One, GMC, two, this... so it was nothing more than that."

Liz Roberts
Reporting from the inquiry

Now the inquiry is discussing a one-to-one meeting Chambers had with HR director Sue Hodkinson on 12 May - the same day as the second meeting with Cheshire Police.

De la Poer says Hodkinson says she was surprised and disappointed by what Chambers was saying in that meeting.

There was a discussion - that was never implemented - about how to manage some of the doctors out of the trust, including talk of a referral to the General Medical Council (GMC). Hodkinson has previously said she challenged Chambers about this in the meeting.

Chambers says: "I don’t remember the meeting, I do remember the context around the meeting."

"What was clear at the outcome of that meeting was that the police were themselves not sure whether this met the threshold of a criminal investigation," he adds.

"I was very clear before any decision could be made that there wouldn’t be an investigation that they should meet with the doctors again, which they did within a few days. And that led to the commencement of Operation Hummingbird."

• A reminder: Operation Hummingbird is the name of the criminal investigation into Letby by the Cheshire Police, launched in May 2017.

Judith Moritz
Special correspondent, reporting from the inquiry

The inquiry hears that medical director Ian Harvey wrote to the consultants on 1 March 2017, warning them of a referral to the regulator, the General Medical Council (GMC).

Chambers says he was not aware of this at the time.

Judith Moritz
Special correspondent, reporting from the inquiry

Nicholas de la Poer KC says the hospital executives’ position in February 2017 was that Letby was going to be allowed back onto the unit. He asks Chambers: "Do you think you were not listening properly to what the consultants [who had concerns] were saying to you?"

"No I don’t think that’s true," he says. "We’d been given really strong messages from the Royal College of Paediatrics and Child Health that the unit was calmer, the unit felt safer."

But De la Poer puts it to Chambers that none of the external expert reviews had dealt with the question: "Has Letby done this?"

Chambers says all of the advice the experts were giving them was that “there was nothing pointing towards unnatural causes".

Judith Moritz
Special correspondent, reporting from the inquiry

The inquiry is shown handwritten notes of 14 February meeting between hospital bosses, after they’d received this letter from the consultants.

Chambers is recorded as saying the doctors "seemed to have gone backwards". Medical director Ian Harvey is noted to have "wondered what they were plotting".

De La Poer notes "plotting is generally what you do against your enemies".

Chambers says "they certainly weren’t enemies any more than we were the enemies."

"We were just ordinary people trying to deal with an extraordinary set of circumstances, with very little or confusing information to hand, and we were trying to make the best sense of that", he says.

"The only thing that there was absolute consensus on was that we didn’t really know what the absolute causes of unexplained death were."

Judith Moritz
Special correspondent, reporting from the inquiry

The consultants sent a letter to Chambers on 10 February 2017, after meeting with the former hospital executive in January. By now they had seen the full reports by the RCPCH.

In the letter they make several points, including that there had been no deaths or unexpected resuscitations on the unit since Letby was taken off duty in July 2016.

Chambers is asked if this letter was reasonable. He accepts that it was, saying the points the doctors make are "not quite as simple as described here, but these are fair points".

He adds: "There’s never been a doubt in my mind, ever, that these doctors had the safety and well-being of these babies at the forefront of their minds."