A nursing director at the hospital where child serial killer Lucy Letby was employed has disclosed why she did not check over the so-called “drawer of doom”, containing concerns about young patient safety.
During the time when Letby attacked babies at the neonatal unit between June 2015 and June 2016, Alison Kelly was director of nursing at the Countess of Chester hospital. After consultant paediatricians told Ms Kelly and others that they believed she could be deliberately harming babies, Letby was moved to an administrative role in July 2016, reports the Mirror.
Despite this, police were not called to investigate until May the following year, after hospital bosses opted to commission a series of reviews into the increased mortality on the unit. As she gave evidence on Monday at the Thirlwall Inquiry, Ms Kelly said: “I would like to express my condolences to all the families and I’m really sorry for all the distress that the families have experienced over the last few years, and are currently experiencing as we sit here today.
“I didn’t get everything right. However the decisions I made were with the best intentions.” She agreed that one of the consultants, neonatal clinical lead Dr Stephen Brearey, told her in a May 11, 2016, meeting about his concerns about the increase in deaths but said he did not mention fears of deliberate harm.
The inquiry were previously made aware that Dr Brearey told another executive that he had a “drawer of doom” full with Letby-related information. Counsel to the inquiry Nicholas de la Poer KC asked Ms Kelly: “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 was.”
Ms Kelly replied: “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.” Mr de la Poer said: “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.” Ms Kelly: “I could have done, yes in conjunction with the medical director.”
According to Ms. Kelly, at another stage of the inquiry, consultants informed her and senior managers that some newborns had not responded to resuscitation as expected and that there had been a pattern of six out of nine deaths happening at night, which ceased when Letby was switched to days.
But Ms Kelly said management were “balancing that” with the “nursing views of her practice and how highly regarded she was thought of”. She said: “We needed to get more facts, we needed to pull more things together to see what the fuller picture was at the time.
“We had no actual evidence as in nobody had seen her do anything. There was broadbrush statements, there was no evidence provided to us at that time. “I think we needed to look at everything in the round in terms of clinical outcomes as well as looking at one individual.
“I didn’t take the hearsay of consultants as evidence at the time.” Ms Kelly denied she had not taken the concerns “seriously enough”.
Counsel to the inquiry Nicholas de la Poer KC asked: “Do you think there is any possibility that things had become so acrimonious with doctors versus nurses and with you backing the nurses, that a culture of fear had developed?” Ms Kelly said: “I would not say a culture of fear. 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.
“There was lots of engagement, it was just tense at times which is why we gained advice from external agencies and the police eventually.” She said: “It became divisive between the nurses and the doctors, and that’s not conducive to good working.”
She agreed it was “not unheard of” for a nurse to deliberately harm patients, but said that was “not in the forefront of my mind”. Ms Kelly went on: “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 said the consultants were still not expressing clearly why they thought Letby was murdering babies, which she found “quite frustrating”. Explaining why police were not called in by the hospital to investigate in the summer of 2016, she said: “I think we had a general conversation about the fact that we all personally needed to know and understand what was actually going on in our organisation so that we could clearly articulate to the police what the problems were.
“At the time, we didn’t really have a sense of what was going on.” Letby, 34, from Hereford, is serving 15 whole-life orders after she was convicted at Manchester Crown Court of murdering seven infants and attempting to murder seven others, with two attempts on one of her victims, between June 2015 and June 2016.
The inquiry, sitting at Liverpool Town Hall before Lady Justice Thirlwall, is expected to sit until early 2025, with findings published by late autumn of that year.
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