UK - Lucy Letby - Post-Conviction Statutory Inquiry

[Tortoise]

Concerns raised about Letby in 2016
10:49​

Alison Kelly has accepted that concerns about Lucy Letby were first raised with her in March 2016.

'I didn’t take the hearsay of consultants as evidence,' Kelly says
10:55​

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."

Kelly accepts safeguarding referral 'wasn't detailed enough'
10:59​

Alison 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."

Formalised whistleblowing process wasn't 'fully embedded', Kelly says
11:15​

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.

Questions on whistleblowing process continue
11:24​

Image source,Thirwall Inquiry

At 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.”

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Failure to record consultants' concerns 'fell by wayside'
11:36​

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”.

11:39​

The consultants’ concerns were eventually logged under the Speak Out Safely scheme in June 2016. (my note - wrong date??)

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".

Kelly asked about claims hospital had 'culture of fear'
11:48​

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".

Kelly says it's upsetting to think people feared her
11:52​

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."

Letby's parents 'very keen' for consultants to be referred to regulator
11:55​

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.

12:07​

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.

Questions focus on how much information was shared with regulator
12:21​

The questioning is centring on what information and documentation was – or wasn’t – provided to the Care Quality Commission (CQC) before and after an inspection which rated the hospital as “good” in 2016.

Kelly denies misleading the CQC at an engagement meeting in 2017.

She says: "It may have been helpful to share more with our regulators at the time, but it was a really complex set of circumstances… and at that time nothing was leading down a route to somebody deliberately harming babies."

She adds: "Perhaps we should have shared a bit more information at the time, but we were still gathering information internally."

Consultants' concerns over baby deaths not passed on to regulatorp
12:34​

The inquiry is shown handwritten minutes of a meeting of the hospital executives on 14 February 2017 where the consultants are noted to have raised concerns that the deaths of babies on the neonatal unit were “not natural causes”. Three days later, Alison Kelly was at the ‘engagement’ meeting with the CQC, and this was not mentioned to the regulator.

Counsel to the inquiry De la Poer asks Kelly: "You needed to tell the CQC about what was going on in your trust and that didn’t happen did it?"

Kelly replies that "we did tell the CQC but we didn’t give them that level of detail because we didn’t know ourselves at that time".

De la Poer continues: "What other external bodies are being told is everything apart from the consultants' concerns - do you think that’s a fair characterisation of the period up until the end of April 2017?"

Kelly replies that "looking back we should have perhaps mentioned that as well at the time. However we were really keen to fully understand what was going on but perhaps those consultant concerns should have been mentioned in the beginning."

De la Poer asks if "finding out absolutely everything that’s going on is the opposite of the correct approach to a safeguarding issue, do you agree?"

Kelly responds: "Yes but we were not considering this as a safeguarding concern."

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Kelly questioned over delay in response to Letby concerns
12:46​

The inquiry hears that on 21 March 2016 Letby’s line manager, Eirian Powell, sent an email to Kelly, which contained a staffing analysis which showed Letby was a common presence at the babies’ deaths until that point.

Kelly didn't respond to the email, so on 14 April 2016 Powell chases, with an updated version of the attached document – this time with Letby’s name highlighted in red.

It was then another 14 days before Kelly’s secretary arranged a meeting – not scheduled until 4 May 2016.

12:48​

On 4 May 2016, Alison Kelly forwards the updated staffing analysis which shows Letby’s name in red, to another executive - Karen Rees, director of nursing in the urgent care division.

She writes: “Please see attached, Lucy Letby highlighted in red!! I have not noticed this when I first reviewed.”

Kelly denies she was too slow to respond to Letby concerns
13:10​

The questions are still focusing on an email sent to Kelly which highlighted concerns about Letby, and the counsel to the inquiry asks: "To put it bluntly were you too slow to acknowledge and act upon these concerns?"

Kelly says: "It does feel that it was a big delay. It could have been looked at in a much more timely way."

The counsel to the inquiry asks Kelly if she was "too slow".

"I don’t think I was to be honest. I think if somebody’s got something so urgent that they want me to see, then why not come to my office? Or why not phone me up? Unfortunately, everything gets lost in hundreds of emails," Kelly says in response.

She's asked if she should have been more attentive than she was.

"Looking back, maybe I should have been yes," she says.

In response to another question, Kelly says that she didn’t open the email attachment which showed that Letby had been a common present at babies’ deaths because “the workload of an executive director of a 600-bedded hospital is huge”.

Kelly asked if she went into a meeting with a closed mind
13:24​

Prior to the break at lunch, we also heard a couple more exchanges at the inquiry. Alison Kelly is asked about a meeting on 11 May 2016. Those present include herself, the Medical Director Ian Harvey, Letby’s line manager Eirian Powell, and the lead neonatal consultant Dr Steve Brearey.

De la Poer: Do you think there’s a possibility that you went into the meeting on 11 May closed minded?

Kelly: No

De la Poer: Was it adversarial?

Kelly: No not adversarial, I think we felt at the time there was still a view that nobody had seen anything, there had been no results provided to us, there was nothing that suggested that there was anything serious going on.

13:26​

De la Poer: If there really was a murderer on your unit why would the clinicians necessarily have seen or heard anything? Because such a person is going to act in a covert way…

Kelly: Yes but when you have things reported to you as in, ‘we have a gut feeling’, ‘I have a drawer of doom’ - it’s not giving you confidence that you have the information that you need.

De la Poer: You were an executive director. If that was troubling you, did you ever say to Dr Brearey, I need to see in your ‘drawer of doom’? You had the authority to do that.

Kelly: I could have done, yes in conjunction with the medical director.

For context - the Inquiry has previously heard that Dr Brearey told another executive, Karen Rees, that he had a ‘drawer of doom’ filled with information about Letby.

Kelly pushed on 'drawer of doom' on Letby
13:28​

De la Poer: Did you say to Dr Brearey, ‘I need to see what’s in that evidence drawer?’

Kelly: No not directly

De la Poer: Why didn’t you do that?

Kelly: It was a very random thing to have shared and I didn’t know what to think because I didn’t know if it was a figure of speech, or whether it actually was a drawer of documents that weren’t being shared.

De la Poer: Did you think he was lying? Dr Brearey? When he said he had evidence in his drawer?

Kelly: I didn’t know what to think. It just seemed a very unusual thing to say.

De la Poer: Was it an unusual thing that you never asked to see it?

Kelly: I didn’t know if it was actually a physical drawer or a figure of speech.

Inquiry returns after breaking for lunch
13:49​

We're now back from a break.

Letby has been convicted of murdering seven babies, and attempting to murder a further seven between June 2015 and June 2016.

The last of the deaths were two triplet brothers, baby O (23 June 2016) and baby P (24 June 2016).

Kelly is now being asked about events on that last day – 24 June 2016.

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Baby baby Jane]

The nursing staff, HR, Sr Mgt contempt for the consultants is really shocking. It seems to be exaggerated poisonous hate-ism of the consultants … why, because they “superior” in training, education, medical knowledge, experience & decision-making ?
The whole NHS is level & grade … it’s not a flat organization with no hierarchy!
The “I don’t talk to consultants” attitude is just scary.
Makes me nervous of nurses & everyone else now. The consultants seem to be the ones in this case with ability to think clearly and are surrounded by incompetent angry jealous hospital, union, HR, mgt…

However,
If the consultants truly did/do think these nurses & other administrators are useless … they would be mostly correct. And would make their jobs more risky & patients in more danger.

 

[Tortoise]

Kelly 'didn't do anything' after being told of concerns Letby harming babies
14:04​

On 24 June 2016 two consultants - neonatal unit lead Dr Steve Brearey and paediatric lead Dr Ravi Jayaram - told the director of nursing for urgent care, Karen Rees, that they were concerned that Letby was intentionally harming babies.

Rees passed that on to her boss, Alison Kelly.

Kelly is asked what she did with this information. She says: "Personally, I didn’t do anything.”

Counsel to the inquiry De la Poer asks "this is a concern of the highest degree of magnitude wasn’t it?"

Kelly replies: "Well there were concerns being raised."

De la Poer presses her: "No listen to my question please. This was a concern of the highest degree of magnitude, wasn’t it?"

Kelly replies: "It was a serious concern, yes."

De la Poer then asks: "You don’t accept the characterisation that it was a concern of the highest degree of magnitude? You don’t accept that it was very, very serious?"

Kelly replies that it was "serious but I felt we were doing the right things".

De la Poer then asks: "Did you discover that Lucy Letby was due to work that weekend?" to which Kelly says she was "unaware of that".

De la Poer presses further: "Did you ask Karen Rees to find out if Lucy Letby was due to work?"

"No I didn’t at the time," Kelly replies.

14:13​

The counsel to the inquiry is continuing to probe Kelly on how she acted when she heard concerns that Letby was harming babies, and he asks Kelly if she was taking those concerns seriously.

Kelly responds: "I was taking it seriously, as a director you did not do every single action that is required of you. You have a team to do that."

She says she was satisfied with the approach of the director of nursing for urgent care, adding: "I recognise I didn’t ask the specific question 'is Letby working tomorrow'? On reflection I could have done something differently and maybe that was a missed opportunity."

The counsel to the inquiry says: "This is exactly the sort of situation that calls for an executive director to be involved directly and personally, isn’t it?"

Kelly says: "What we know now compared with what we knew then… you could say yes, but we don’t have capacity as executives to do every single action."

Counsel de la Poer responds by asking what was "more pressing than the suggestion by two consultants that a member of staff may just have committed murder?"

Kelly says she felt like she needed "some concrete evidence", adding: "It just felt like they were being quite blasé about the statements that they made and it was a very difficult thing to hear, so maybe I didn’t process it as I should have done at the time."

She's asked if it was simply that she didn't believe the consultants, and Kelly says: "I didn’t not believe them, I just wanted some evidence."

"I think it was just really, really difficult and looking back perhaps I could have done something differently but at that time myself and Karen Rees felt we were taking the right action," she says.

It's put to her that that action did not include taking steps to protect babies if Letby did pose a risk, and Kelly adds: "That is difficult to hear, but maybe I should have done something differently at that time, yes."

Directors invited to meeting by consultants - neither went
14:16​

Dr Brearey had repeated his request for Letby to be suspended from duty - but this wasn’t immediately granted.

The second triplet died on a Friday, 24 June 2016. That Sunday (26 June) Dr Brearey invited Kelly and medical director Ian Harvey to a meeting so that the consultants could put their concerns to them directly. Neither executive went. Asked why, Kelly says she does not have access to her diary as part of this inquiry.

Hospital managers held Letby meeting without input from consultants
14:18​

On the following day - Monday, 27 June - the executives, and nursing managers, had a meeting but the consultants were not invited to be present.

An action plan regarding Letby was formulated at this meeting of managers, without input from the consultants.

Counsel to the inquiry de la Poer asks "were they being excluded from it so a plan could be formulated without reference to them?"

"No'" Kelly replies.

Kelly: Idea of nurse harming patients was not at the forefront of my mind
14:21​

The counsel to the inquiry is still pushing Kelly on why more was not done to prevent Letby from working after concerns had been raised about her.

He says: "The one action that could have addressed the consultants’ concerns – that Lucy Letby had committed murder – would have been to stop Lucy Letby from working that week."

Kelly says: "I was under the impression she wasn’t at work, but I have found out since from this inquiry that she actually was."

"I suppose I found it quite difficult to comprehend... I was in charge of over 1,000 nurses and midwives and the last thing on my mind is that one of my nurses is deliberately harming children or babies or adults," she adds in response to another question.

Put to her that such a thing is not unheard of, Kelly says: "It’s not unheard of, but that was not at the forefront of my mind."

'How would nursing manager know Letby was murdering babies?' KC asks
14:23​

Nicholas De La Poer asks: "Here you have extremely credible, knowledgeable, people telling you that that is what they think the risk is, and you don’t even appear to be talking about how you might address that risk?"

"I was relying on my senior nursing team to give me assurances on Letby and I made an assumption that everything was OK," Kelly replies.

Kelly is then asked how the nursing manager Eirian Powell would know that Lucy Letby was murdering anybody.

She explains that Powell wouldn't have known, but would have raised concerns should she have had any doubts about an individual.

"Is this meeting an example of how it degenerated into doctors versus nurses?" De La Poer presses.

Kelly responds: "No not at all. Throughout this process we were really keen to hear from doctors and nurses and this was a team that before all this worked really well together, and it’s unfortunate that it became divisive between us and that’s not conducive to good working ."

Questions over process managers used when deciding to call in police
14:24​

Alison Kelly is now being asked about the process that hospital bosses went through when deciding whether to involve the police.

This takes us to the end of June 2016, in the timeline of events - so after all of the murders and attempted murders that Letby has been convicted of, had happened.

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Involving police 'didn't feel like right thing to do at time', says Kelly
14:28​

Kelly is asked about the decision not to involve the police at this point at the end of June 2016 – after all of the murders and attempted murders for which Letby was later convicted.

Kelly responds: "It didn’t feel like the right thing to do at that time, we felt we needed to get more information."

"We all personally had to understand what was going on so that we could then clearly articulate to the police what the problem was, because at that time we didn’t really have a sense of what was going on," she adds.

Letby boss told regulator 'no evidence' of nurse causing deliberate harm
14:34​

Alison Kelly is asked about her dealings with Letby’s regulator, the Nursing and Midwifery Council (NMC).

On 4 June 2016 Kelly contacted the NMC. She told them that there was no evidence of Letby causing deliberate harm.

Picking up on this, de la Poer asks: "From 27 April 2017 you knew the police were going to be involved. You didn't contact the Nursing and Midwifery Council to tell them that did you?"

Kelly says that she doesn't recall whether she did, and de la Poer suggests that the NMC found out through a press release and called Kelly after.

"I think we communicated with everybody - unless the NMC was inadvertently left off that list," Kelly responds.

After this, Kelly agrees that in March 2017 her belief was that the likely explanation for all the babies' deaths was poor care on the neonatal unit.

Regulator learnt of Letby's arrest in July 2018
14:41​

The Nursing and Midwifery Council found out about Lucy Letby’s arrest on 3 July 2018. Alison Kelly then referred the nurse to the NMC the following day.

14:50​

Jumping back in the timeline to September 2016, eight months before the police were involved, a team from the Royal College of Paediatrics and Child Health was invited by executives to come into the hospital and review the neonatal unit.

The head of that team has previously told the inquiry that Kelly was particularly supportive of Letby and quite dismissive of the allegation against her.

Counsel to the inquiry Nicholas de la Poer asks Kelly to respond to this claim

“I’ve never been dismissive. We took this very, very seriously. I certainly wouldn’t say I was dismissive at all," Kelly says.

No disciplinary investigation into Letby by hospital trust
14:52​

The inquiry hears that the Countess of Chester Hospital Trust never initiated any disciplinary investigation into Lucy Letby.

Report kept private
15:11​

The inquiry now turns to a review by the Royal College of Paediatrics and Child Health (RCPCH), which was published in February 2017.

Two reports were produced – one had Letby's name in it but it was redacted and kept private by executives at the hospital.

The counsel to the inquiry puts it to Kelly: "It put patient safety at risk didn’t it, not sharing that report as soon as it was available didn’t it?"

Kelly responds: "You could say that, yes."

Letby won grievance claim after she was taken off duty
15:15​

Alison Kelly is told that she will now be asked about the grievance procedure which Letby raised in September 2016, after being taken off nursing duty, against her wishes, after concerns were raised about her.

This grievance was upheld in Letby’s favour.

'Would have been better' if grievance process overseen by someone independent, says Kelly
15:28​

Kelly says she accepts that “on reflection it would have been better” if the grievance process – raised by Letby – had been overseen by somebody independent, rather than the director of pharmacy at the hospital, a doctor who knew people involved.

Kelly accepts she made 'misleading' statements
15:29​

Alison Kelly accepts making “misleading and potentially false” statements in her interview with the doctor who was investigating Letby’s grievance complaint.

She told Dr Chris Green, the person investigating Letby’s grievance, that there were “no immediate actions” pending against the nurse, whereas the trust had been given external advice that they should commence disciplinary proceedings against her.

She says: “I recognise that was misleading."

Kelly communicated to grievance investigator she expected Letby to return
15:40​

Sticking with the information Kelly provided to a grievance complaint that had been raised by Letby and was being investigated, the counsel to the inquiry puts it to Kelly that she communicated to the investigator in an interview that she expected Letby to return to the unit.

"We needed to make an assessment of whether she was going back on the unit," Kelly says.

The counsel to the inquiry asks: "Did you think it was a bit premature when you hadn’t had the outcome of the review?"

Kelly responds: "It probably was a little premature. We needed to get a full picture."

"It was complex," she says, adding: "There was an individual in the middle of this, as well as a group of consultants who were upset by this process."

Nursing director spoke to Letby during ongoing investigation
15:44​

In November 2015, whilst Letby’s grievance complaint was still being investigated, director of nursing Alison Kelly met with her in person.

Asking about this, de la Poer KC says: "Here is you, a witness in the grievance, whilst the grievance is going on, having a meeting with her telling her that she is going to go back on the unit - do you see that?"

Kelly accepts that this meeting was a "conflict".

"I have reflected a lot on the involvement of myself and the conversations I had with Lucy Letby and if I knew then what I know now, that would not be my normal practice," she adds.

De la Poer presses her further, saying: "You were telling Letby before the investigations had been concluded that she was going back on the unit."

Kelly admits this, and calls her actions "premature".

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Inquiry asks why Letby sent back to unit before investigation completed

15:48​

The questioning of Kelly's meeting with Letby continuing, with counsel to the inquiry de la Poer asking her: "Is that because you had closed your mind to what those reports might reveal and you had a single objective which was to get her back on the unit?"

Kelly replies: "It wasn’t a single objective. It was premature of me, but we were keeping an open mind and not trying to have doctors vs nurses which eventually ended up feeling like that."

De la Poer asks if "telling Lucy Letby that she was going back on the unit before the investigation was completely the opposite of having an open mind?"

"I think I disagree with that," replies Kelly.

"I think there was a lot going on and the conflict was that I was the professional lead for nursing and wasn’t helpful in the conversation we were having there. But yeah I’ve reflected on that, and it could have been done differently in light of the other investigations that were going on."

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Kelly 'can't recall' why she didn't mention doctor's comments
16:00​

Alison Kelly is asked why she didn’t mention Dr Jayaram’s comments in her later communications with a range of external bodies including the Nursing and Midwifery Council and the police.

De la Poer asks: “Is the position that you just forgot about it?”

Kelly answers: “I can’t recall."

Kelly now facing questions from barrister on behalf of babies' families
16:00​

Alison Kelly is now being questioned by Richard Baker KC who is asking questions on behalf of some of the babies’ families.

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Now I see why Letby wanted to return to the NNU.

She had them in 'check' on her chess board.

Thank God the consultants had the last move.

 

[Tortoise]

Nursing director says concerns missed because she had hundreds of emails each day
16:21​

Alison Kelly is being led through a series of emails between herself and other senior managers at the hospital.

She tells the inquiry that she was never given “a full picture” and there was nothing that significantly raised concerns at that time, regarding Lucy Letby being on shift when a number of babies collapsed or died.

She told the inquiry earlier in the day that as director of nursing she was getting sometimes hundreds of emails a day.

Richard Baker KC asks her if she’s being honest that she didn’t fully read one email that referenced high mortality and the commonality of a particular nurse, and didn’t open an attachment that had more details.

Alison Kelly says she can’t recall, but that at the time it didn’t raise significant concerns and that sometimes email isn’t a great form of communication for putting serious matters across.

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Tortoise]

Consultants went on to tell Ms Kelly and senior managers that there had been a pattern of six out of nine deaths occurring at night and the pattern stopped when Letby was moved to days, and that some babies had not responded to resuscitation as expected.

But Ms Kelly said management were “balancing that” with the “nursing views of her practice and how highly regarded she was thought of”.

[...]

“I didn’t take the hearsay of consultants as evidence at the time.”

Letby safeguarding chief tells inquiry she had ‘best intentions’

Alison Kelly was director of nursing at the Countess of Chester Hospital during the period when Lucy Letby attacked babies on the neonatal unit.

www.independent.co.uk

Looks very much to me like evidence. Maybe they were waiting for a signed confession.

 

[Tortoise]

16:46​

Did delays allow Letby to murder? lawyer asks​

Continuing with the questions about emails, Baker shows Alison Kelly an email she sent to the medical director of the hospital, Ian Harvey.

He says that between March and May of 2016 there were a number of “red flag” emails that needed action and, he says, no action was being taken.

The lawyer asks the former director of nursing if the delays in doing anything allowed Lucy Letby to murder the children of the families he represents.

Kelly says she has reflected on this. She says she doesn’t know why there were delays but there was a lack of urgency to hold meetings and things “ticked along” longer than they should have done.

Baker wonders what should have been done, asking her: “Were you too busy to do your job?”

“I was a very busy person and my portfolio was very large and getting through emails was difficult,” she responds.

Baker then asks why she didn't raise this with the hospital.

“Everyone else in my position would be in exactly the same position in terms of workload... I rely on the rest of my team to flag concerns to me," Kelly answers.

Kelly accused of lying to mother of murdered baby​

​

Baker then talks about a meeting one of the mothers of the murdered babies said she had with Kelly in July 2016.

“You were aware that concerns had been raised about the conduct of Lucy Letby and were aware of a number of reports being launched by the hospital. Do you remember meeting the mother of Child C?” He asks.

“I have reflected on this,” says Kelly. “I’m not saying the meeting didn’t take place but I don’t recall meeting the parents of any babies at that time.”

The mother had read an article in a local newspaper about an investigation that had been launched into the number of deaths on the neonatal unit.

At the meeting, the mother says she was told the investigation was “more of a formality". Mr Baker says Mother C was pregnant at the time, her previous child had died, murdered by Letby.

He tells the inquiry the mother remembers the meeting fully and says what she was told at the time was not the whole truth and that details of where the investigations were up to were incomplete.

“You lied to her,” says Baker.

“I don’t recall that meeting, honestly,” she replies.

“I can’t imagine any of the families wanted to be lied to,” says Baker.

'No obvious safeguarding issue' around Letby behaviour, boss says
17:33​

Erica Witherington
Reporting from the inquiry

Peter Skelton KC, representing the parents of several of the babies, has been asking why Kelly - who was in charge of safeguarding - did not trigger a safeguarding process when the concerns about deliberate harm towards babies were brought to her attention.

He says: "To be clear, the likely event that would have occurred, had you triggered that process would have been the police would have been alerted and Letby - in all likelihood - would have been suspended pending an investigation to check safety at the unit."

Alison Kelly concedes this, but insists that at the time, it did not feel obvious to her that it was safeguarding issue.

“Everybody looked at this though a mortality lens, not a safeguarding one," she explains.

Letby's former boss accepts she made 'misleading' statements after nurse raised complaint

Alison Kelly was director of nursing at the Countess of Chester Hospital where Letby murdered seven babies and attempted to murder seven others.

www.bbc.co.uk

 

[Parker Knoll]

Dear god.
Simply unbelievable.

 

[katydid23]

De la Poer continues: "What other external bodies are being told is everything apart from the consultants' concerns - do you think that’s a fair characterisation of the period up until the end of April 2017?"

Kelly replies that "looking back we should have perhaps mentioned that as well at the time. However we were really keen to fully understand what was going on but perhaps those consultant concerns should have been mentioned in the beginning."

De la Poer asks if "finding out absolutely everything that’s going on is the opposite of the correct approach to a safeguarding issue, do you agree?"

Kelly responds: "Yes but we were not considering this as a safeguarding concern."

THAT^^^^ last statement really ticked me off----how could unexplained dead babies NOT be a 'safeguarding' issue?

 

[MrsAddick]

Dear god.
Simply unbelievable.

This level of wilful ignorance is truly shocking…or is it wilful incompetence

 

[MrsAddick]

De la Poer continues: "What other external bodies are being told is everything apart from the consultants' concerns - do you think that’s a fair characterisation of the period up until the end of April 2017?"

Kelly replies that "looking back we should have perhaps mentioned that as well at the time. However we were really keen to fully understand what was going on but perhaps those consultant concerns should have been mentioned in the beginning."

De la Poer asks if "finding out absolutely everything that’s going on is the opposite of the correct approach to a safeguarding issue, do you agree?"

Kelly responds: "Yes but we were not considering this as a safeguarding concern."

THAT^^^^ last statement really ticked me off----how could unexplained dead babies NOT be a 'safeguarding' issue?

She quite clearly doesn’t know the definition of the thing that she’s in charge of.

 

[Tortoise]

25/11/2024 – Transcript of Week 11 Day 1 | The Thirlwall Inquiry

Transcript of Part B Evidence: - Alison Kelly, Director of Nursing

thirlwall.public-inquiry.uk

Alison Kelly - full transcript

 

[Tortoise]

Q. [...] You had a meeting on 11 May of 2016 which included Dr Brearey; is that right?

A. That's correct, yes.

[...]

Q. So we are just going to focus upon my question which didn't include the phrase "deliberate harm". It was that he was concerned that the increase in neonatal mortality may be due to Letby?

A. May be due to Letby, yes.

Q. If it is due to her, there are only twopossibilities, do you agree? One, that she is doing so inadvertently, potentially through incompetence; or two, she is doing so deliberately?

A. Yes.

[...]

Q. Of course as to the issue of inadvertent or incompetent harm, you had very strong reassurance, didn't you, in that meeting from Eirian Powell and Anne Murphy that incompetence was unlikely?

A. Yes.

Q. Because they were telling you what a good nurse she was?

A. Yes.

Q. So on that basis if Dr Brearey was correct in his concern, or may be, if anything, does that not increase the fact the possibility that it is deliberate?

A. From his perspective there was a possibility that that was deliberate. But as we were talking through the information that we had to hand at that meeting, including detailed analysis of cases which pointed to some clinical issues, we were open at that meeting to what the causes could be. From a perspective -- from a nursing perspective, that could have been a competency issue.

[...]

Q. You were in a unique position that day in that meeting, weren't you, because you were the Executive Lead for Safeguarding?

A. Yes.

Q. The only safeguarding role person in the meeting?

A. Yes.

[...]

Q. Now, you say it never came up. I would like you to just deal directly, please, with this. Did you have a responsibility to bring it up because you were the Executive lead?

A. On reflection, yes, as a lead at that time. But I wasn't at that meeting thinking about safeguarding at that time.

https://thirlwall.public-inquiry.uk/wp-content/uploads/2024/11/Thirlwall-Inquiry-25-November-2024.pdf

 

[Baby baby Jane]

All of these non-consultants seem so rehearsed, their words so carefully crafted, certainly by the lawyers hired by their unions or insurance to avoid liability.
It’s annoying … wish they would tell the truth in their own words.

When Kelly should have said “Yes” she said

“looking back we should have perhaps mentioned that as well at the time. However we were really keen to fully understand what was going on but perhaps those consultant concerns should have been mentioned in the beginning.”

 

[MrsAddick]

All of these non-consultants seem so rehearsed, their words so carefully crafted, certainly by the lawyers hired by their unions or insurance to avoid liability.
It’s annoying … wish they would tell the truth in their own words.

When Kelly should have said “Yes” she said

“looking back we should have perhaps mentioned that as well at the time. However we were really keen to fully understand what was going on but perhaps those consultant concerns should have been mentioned in the beginning.”

Imagine being a parent who has lost a child have to sit and listen to a robotic beaurecrat repeatedly say “with hindsight…” “on reflection…” “at the time” “perhaps I should have” “well intentioned…” blah blah blah. Poor families being fed responsibility-dodging rubbish