Alex Smith
Live reporter

Sir Duncan Nichol - the former chairman of the Countess of Chester Hospital - has finished giving his testimony to the Thirlwall Inquiry into how the hospital handled Lucy Letby's case.

He has apologised for the "unimaginable grief for the families whose babies died", and on multiple occasions he said the hospital had "failed" to keep babies safe in its care.

The former chairman says he apologised to doctors in 2017, soon after the police investigation began, for not intervening sooner. Consultants in Letby's department had been raising concerns about a rise in baby deaths for months before the police were called to investigate.

In June 2016, one doctor warned a board meeting the hospital was in "a Beverley Allitt / [Harold] Shipman situation". At that same meeting the clinical lead on Letby's unit said it would remain unsafe unless she was moved.

Nichol had been leading the NHS Management Executive at the time of Allitt's conviction - another nurse found guilty of killing those in her care - but says the case and its recommendations were not "in the forefront" of his mind.

A few weeks later, another doctor on the ward called suspicions over Letby the "elephant in the room" - but Nichol says the hospital's then-medical director had "drawn our attention to the possibility that multiple factors" lay behind the rise in baby deaths.

For more on what has been said across the dozens of hearings at the inquiry so far, listen to Lucy Letby: The Public Inquiry on BBC Sounds.

We're ending our coverage now, but you can read our summary of Sir Duncan Nichol's evidence in our main story.

This page was edited by Emily Atkinson. The writers were Judith Moritz, at the inquiry, Alex Smith and Adam Goldsmith.

In case you weren’t able to follow along live, here’s a summary of the key lines from Sir Duncan Nichol this afternoon:

• At a meeting on 30 June 2016, at which Nichol was present, one doctor warned that the neonatal unit at the Countess of Chester Hospital would remain unsafe until Lucy Letby was removed
• Nichol told the inquiry the consensus was to “undertake external inquiries”, instead of calling the police

• The same day, he first learned of the “spike" in baby deaths on the unit, he said

• Sir Duncan said it was a "serious failure" that the case of serial killer Beverly Allitt was not "at the forefront" of his memory when approaching decisions on Letby
• Nichol finished with a statement, where he accepted that the Countess of Chester Hospital “failed to keep babies safe”, and apologised for the “unimaginable grief” suffered by their families

Judith Moritz
Special correspondent, reporting from the inquiry

After questioning finishes, the inquiry chair, Lady Justice Thirlwall, gives Sir Duncan Nichol an opportunity to give a statement to the inquiry.

Nichol is visibly emotional as he says: "I’ve never encountered a situation which has generated as much angst and stress as this one".

Choking up, he continues: "I wanted to say that the Countess of Chester Hospital failed to keep babies safe in their care, and that’s something that I found very very stressful over time."

"And more importantly that caused unimaginable grief for the families whose babies died and I am so sorry that that happened in the way that it did", he says.

And with that, Nichol finishes his evidence.

Judith Moritz
Special correspondent, reporting from the inquiry

Now the inquiry moves on to the decision to send the babies' families a redacted version of the 2016 report by the Royal College of Paediatrics and Child Health (RCPCH).

Nichol says he believes it was the right thing to do.

"And therefore keeping them in the dark?" Woods asks. Nichols says "I wouldn't put it that way".

Judith Moritz
Special correspondent, reporting from the inquiry

Woods continues, asking "what more can be done" at an executive level to ensure families are not kept in the dark and are not kept outside when things go wrong?

Nichol says "we just have to reinforce the key messages of good governance and good board practices".

Asked if he has thought of anything more radical, he says "I think we failed".

He adds that while they were in the middle of a "hugely complex process" that didn't they shouldn't have kept families informed along the way.

Judith Moritz
Special correspondent, reporting from the inquiry

Although Nichol was running the NHS at the time of the Allitt scandal, and was responsible for disseminating the recommendations made by the inquiry into the case, he says it "[was] not in the forefront of my memory" when it came to the Letby situation in Chester.

Asked by Woods where the babies' families were in the big picture, Nichol says they "were not".

"We didn’t exercise an appropriate duty of candour towards the families and that was a failure. A serious failure."

Judith Moritz
Special correspondent, reporting from the inquiry

Nichol is now being questioned by Leanne Woods, on behalf of the second group of babies’ families. She says she wants to take him back to the case of Beverley Allitt.

Some context: Allitt, a former nurse, was convicted of murdering babies in her care in 1991. At the time, Nichol was chief executive of the NHS Management Executive, and was tasked with circulating the conclusions of the inquiry into what happened.

Woods says that "presumably it was a significant event both for the NHS and by extension you?"

Nichols replies: "Very much so."

Judith Moritz
Special correspondent, reporting from the inquiry

Sara Sutherland is taking Sir Duncan Nichol through the detail of the consultants’ complaints about former chief executive Tony Chambers, which they were making before he resigned in 2018.

She asks the former hospital's chairman if he agrees that Chambers was “not a fit and proper person”, to which Nichols says he does not.

"I think he was in the middle of a process. I don’t believe the paediatricians were coerced into mediation and these were the views of the paediatricians, but I don’t fully subscribe to the view that Tony Chambers wasn’t a fit and proper person."

"We were in the middle of a process of reconciliation that had no quick fix," he says.

Judith Moritz
Special correspondent, reporting from the inquiry

Image source, Cheshire Constabulary

At that meeting on 30 June 2016, the neonatal clinical lead, Dr Stephen Brearey said that whatever other changes were put into place on the unit, it would remain unsafe until Letby was moved - and that his opinion on the matter wouldn't change.

Sara Sutherland says to Nichol: “You have the head of the neonatal unit saying his opinion wouldn’t change.. so that's the date you should have called the police isn’t it?”

Nichol doesn't agree, saying that "the consensus in that meeting was that the majority - and this was from the paediatricians - agreed that the next steps were to undertake external inquiries”.

Sutherland continues, saying "these were consultant paediatricians who were clearly identifying unexplained deaths of babies on 30 June 2016, there was nothing stopping anyone calling the police was there?"

Nichol replies: "There was nothing stopping anybody calling the police."

Judith Moritz
Special correspondent, reporting from the inquiry

Sutherland puts it to Nichol that the babies’ families should have been included in a meeting on 30 June 2016, when he was discussing the situation with hospital executives.

Nichols disagrees: “I am not sure at this stage whether the families should have been involved… this was the first time that I had heard anything about a spike in deaths."

"We were looking to the principal concern - the safety of babies on the unit and we had actions that we needed to take," he says.

Judith Moritz
Special correspondent, reporting from the inquiry

Counsel to the Inquiry Rachel Langdale KC has now finished her questions for Sir Duncan Nichol.

Nichol is now being questioned by Sara Sutherland, on behalf of some of the babies’ families.

Judith Moritz
Special correspondent, reporting from the inquiry

Earlier in today's hearing Nichol was asked about a letter sent to him, and hospital chief executive Tony Chambers, on 7 July 2017 from Lucy Letby's parents.

We have now managed to get the full wording of the letter, which reads as follows:

Dear Mr Chambers & Sir Duncan Nichol

It is now I year since our nightmare began.

There is a saying "Innocent Until Proven Guilty" but it does not seem to apply to Lucy. She is still the only one of all the staff on the Neonatal Unit to be singled out for punishment.

Whilst we appreciate that things cannot be finalised until the Police Investigation has ended we have to have a way of moving forward in terms of her career for however long the investigation takes.

We therefore wish to request an urgent meeting with you both to discuss what restrictions are on Lucy and what expectations she can have regarding Work/Training for the time until the Police Investigation has been completed.

We would appreciate the meeting to be as soon as possible as the anguish this situation is causing has become intolerable.

Kind Regards

John & Sue Letby

Parents of Lucy Letby

Judith Moritz
Special correspondent, reporting from the inquiry

Image source, The Thirlwall Inquiry

The inquiry resumes with Sir Duncan Nichol, the former chair of the Countess of Chester Hospital, being asked about the period, in 2018, after Lucy Letby had been arrested.

The then-chief executive of the hospital, Tony Chambers, was facing a vote of no confidence, and resigned before any vote could happen.

Nichol says he "spoke to no one to influence the vote of no confidence which I thought was going to take place”.

In his role as chair he conducted annual appraisals for Chambers, and says between 2013-16 he had “exceeded expectations”, but in 2017 and 2018 his performance “had dipped”.

We'll have all the latest lines from Sir Duncan Nichol's evidence shortly.

While the inquiry breaks for lunch - we're expecting it to resume in 15 minutes or so - you can catch up by listening in to Lucy Letby: The Public Inquiry on BBC Sounds.

In this series, you'll find regular updates from Judith Moritz, who summarises the key developments from what she's heard inside the room at the Thirlwall Inquiry.

Today's evidence at the Thirlwall Inquiry heard that, in a June 2016 meeting, a doctor at Lucy Letby's hospital warned "this is a...Shipman situation".

Harold Shipman, a GP from Greater Manchester, was jailed in 2000 for murdering 15 of his patients. All of those victims were woman and none was suffering from a serious illness when she died.

A later inquiry found Shipman killed an estimated 250 people throughout his career in medicine, from 1971 to 1998.

You can watch The Shipman Files: A Very British Crime Storyon iPlayer here.

While the inquiry takes a short lunch break, here's a recap of the key lines over the last hour:

• Sir Duncan Nichol, the former chairman of the Countess of Chester Hospital where serial killer Lucy Letby worked, says he apologised to doctors in 2017, soon after the police investigation began, for not intervening sooner
• A letter that Letby had written was read to consultants in January 2017, something that "aggravated matters and was provocative", Nichol says
• Consultants had been raising concerns about Letby for months, with one doctor telling hospital executives in June 2016 "this is a Beverley Allitt / [Harold] Shipman situation", something Nichol says he doesn't recall
• A month later, another consultant described suspicions about Letby as the "elephant in the room" - but Nichol says the hospital's then-medical director had "drawn our attention to the possibility that multiple factors" lay behind the rise in baby deaths

• A criminal barrister brought in to advise the hospital in April 2017 advised "if events are still unexplained, the police should be called", and Nichol says he wishes he had that advice a year previously

For our earlier recap on the first tranche of questions, click here.

The inquiry has just broken for lunch, and is expected to continue around 14:15 GMT, when Sir Duncan Nichol's questioning will continue.

Judith Moritz
Special correspondent, reporting from the inquiry

The inquiry hears about an email which Nichol sent to consultant Dr Ravi Jayaram on 25 May 2017 - after the police investigation had begun.

In it he wrote: “I want you and your consultant colleagues to know how deeply sorry I am for the personal distress that you have and are all suffering, and for my part in not intervening sooner.”

On the same day as this, Nichol went to find the doctor, and says the pair had an emotional conversation.

"I remember us putting our arms around each other," he says.

Judith Moritz
Special correspondent, reporting from the inquiry

Nichol is asked about a meeting in January 2017, when a statement written by Letby was read to consultants.

Rachel Langdale KC asks if he believes that was an appropriate thing to do, Nichol says "no, I thought it aggravated matters and was provocative".