Hospital Safeguarding Head Claims “Good Intentions” Despite Failure to Act on Letby Concerns

Alison Kelly, who served as the director of nursing and executive lead for safeguarding at the Countess of Chester Hospital, where Lucy Letby committed the murders of seven infants and attempted to murder seven others, informed a public inquiry that her actions were driven by “good intentions,” even though she did not escalate concerns regarding the nurse. According to testimony heard by the inquiry, senior consultant Dr. Stephen Brearey communicated his concerns to Ms. Kelly in May 2016, highlighting Letby’s connection to unexplained fatalities within the unit. However, Ms. Kelly stated that at that specific time, she “just didn’t see it as a safeguarding concern.” The Thirlwall Inquiry, established to investigate the circumstances that allowed Letby to carry out her crimes, was informed that Ms. Kelly did not formally submit a safeguarding referral to the local safeguarding board until March 2018. Testifying at Liverpool Town Hall on Monday, Ms. Kelly explained her reasoning, stating: “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.” Nicholas de la Poer KC, the inquiry’s counsel, questioned Ms. Kelly about her failure to report the doctors’ concerns to NHS England in July 2016. She responded that the choice not to report “was a really fine balance” and that she considered the concerns voiced by medical professionals to be “hearsay.” Nevertheless, she conceded that, in retrospect, it constituted a safeguarding matter and warranted an appropriate response. Ms. Kelly then highlighted, “But neither did anybody else.” She further asserted, “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.” Mr. de la Poer inquired whether she was “deliberately” attempting to “withhold” information concerning potential harm to infants. Ms. Kelly responded: “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 was informed that Ms. Kelly’s safeguarding referral was made in March 2018, nearly a year subsequent to Cheshire Police being initially contacted to investigate unexplained deaths and collapses within the unit. Ms. Kelly acknowledged that the referral was “not detailed enough.” Mr. de la Poer then questioned: “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 replied: “That’s not true.” Furthermore, Mr. de la Poer put forward the idea that relations between doctors and nurses had grown “acrimonious” and that a “culture of fear” had emerged. Ms. Kelly countered, “I would not say a culture of fear,” but conceded, “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.” She concurred that while it was “not unheard of” for a nurse to intentionally harm patients, this possibility had not been “in the forefront of my mind.” Ms. Kelly further elaborated: “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 stated that the consultants continued to lack clarity in articulating their reasons for suspecting Letby of harming infants, a situation she described as “quite frustrating.” During the public inquiry last week, Dr. Brearey recounted uttering the phrase “oh no, not Lucy, not nice Lucy” during a meeting with Ms. Kelly in July 2015. This statement was made after it was discovered that Letby had been present during the deaths of three infants several weeks earlier. However, Ms. Kelly disputed this version of events, telling the inquiry on Monday: “That was not said at the meeting.” She added: “Lucy Letby’s name was not mentioned at all.” Ms. Kelly informed her barrister, Kate Blackwell KC, that her next communication with Dr. Brearey was not until May 2016, at which point he informed her that a nurse had been reassigned to day shifts following connections to several incidents. Ms. Kelly stated that the executive team was “constantly asking questions” of the clinicians regarding evidence and had sought additional information. She further testified that she became aware in March 2017 that consultant Dr. Ravi Jayaram had observed an incident in February 2016, where Letby was present next to the cot of an infant girl identified as Child K. She conveyed to the inquiry: “We were shocked that we had not been told that before.” Ms. Kelly commenced her testimony by extending her condolences to all families impacted by Letby’s offenses. Letby, who was 34 at the time, received convictions for the murders of seven babies and the attempted murders of seven others, which included two attempts on a single infant, occurring between June 2015 and June 2016. She is currently serving 15 whole life sentences. The ongoing public inquiry has reached its 11th week and is anticipated to continue until early 2025.