The inquiry into the case of Lucy Letby, a neonatal nurse convicted of murdering seven babies and attempting to murder seven others, has unveiled critical insights into the management culture at the Countess of Chester Hospital.

Testimonies presented at the Thirlwall Inquiry in Liverpool indicate that Tony Chambers, the former chief executive of the hospital, expressed concerns about the potential for a "wrongful conviction" of Letby following her arrest in 2018.

Dr. Susan Gilby, who became deputy chief executive and medical director shortly after Letby's initial detention, recounted a conversation in which Chambers conveyed his confidence that no charges would ensue.

She described his consistent focus on the lack of an identifiable cause for the incidents, stating: "He kept repeating that there was no single cause found."

Dr. Gilby, who later took over as chief executive, noted her surprise at the atmosphere within the executive team upon her return from abroad at the time of Letby’s arrest.

Contrary to her expectations of shock and concern, Chambers emphasized a belief in Letby’s lack of intent to cause harm.

She expressed her alarm regarding the unexpected collapses and deaths of infants, stating, "Even one of those is a cause of concern."

The inquiry has highlighted that Letby was removed from the neonatal unit in June 2016, following complaints from consultant paediatricians about the rising mortality rates on the unit.

However, a police investigation was not initiated until May 2017, after a series of independent reviews had indicated significant issues.

Dr. Gilby testified that senior leadership, including Chambers and former medical director Dr. Ian Harvey, were dismissive of the consultants’ concerns.

She noted that there was a prevailing belief among executives that the paediatricians were searching for someone to blame when outcomes were not favorable.

Dr. Gilby remarked, “They just felt the paediatricians were unable to accept they weren’t the best.”

In a meeting with Dr. Stephen Brearey, one of the paediatricians who had raised alarms, Dr. Gilby realized early in the conversation that the distressing trends observed were not clinically explicable.

She stated, "You've been here five minutes, you get it," reflecting a shared understanding of the gravity of the situation.

The inquiry has indicated a shift in focus toward institutional accountability, as Dr. Gilby remarked on the prior management’s priorities, saying, "Patients had become lost in the organisation."

Lady Justice Thirlwall, leading the inquiry, made clear that the proceedings do not address the question of Letby's wrongful conviction.

On February 4, an international panel of neonatology and paediatrics experts held a press conference countering claims of deliberate harm by Letby.

Letby’s legal representatives have since submitted a request to the Criminal Cases Review Commission (CCRC) to reconsider her case, including the findings of the expert panel.

The inquiry is scheduled to hear closing submissions on March 17, with Lady Justice Thirlwall's findings expected to be published in the autumn.