‘I acted in good faith’ says Letby trust CEO

A former trust chief executive at the centre of the Lucy Letby scandal has defended his actions, stating both he and other executives were “acting in good faith”.

Tony Chambers, who led The Countess of Chester Foundation Trust from December 2012 until September 2018, spoke publicly for the first time since Letby’s conviction last year, giving evidence to the public inquiry into the events.

Neonatal nurse Letby was convicted last year of murdering seven babies, and attempting to murder seven more, from 2015-16, while working in the hospital.

The Thirlwall Inquiry into the events leading up to convictions has been ongoing since September, and the hospital’s executives have begun giving oral evidence in recent days, facing lengthy questioning.

Mr Chambers told the inquiry on Wednesday: “I stand by the decisions that we made. We were acting in good faith. I was acting in good faith. I listened to the doctors when they raised their concerns. I also listened to the nurses when they raised their support [for Letby].”

Many questions focused on the detail of how Mr Chambers and senior colleagues handled concerns raised by doctors about links between Letby and higher neonatal mortality, including several specific infants.

Since her conviction, Chester paediatricians have accused the executives of pushing back on concerns they raised, rather than taking them seriously. Part of their response was to commission several internal and external reviews.

Mr Chambers defended his actions. “I was being presented with things that, at times, felt quite binary. I never took a binary view. I listened to both. 

“Therefore, Letby was removed from frontline duties and therefore we also focused on the safety of the unit, redesignated [downgraded it so it did not take high-risk cases] and so forth, and all the inquiries that went through were done all in good faith.

“The biggest cause of unnatural, unexplained deaths in maternity and neonatal units is not deliberate harm, but failure in systems of care. There are many examples. The Kirkup report, the Ockenden report, many, many examples.”

Mr Chambers said he first became aware of concerns about Letby’s role on 29 June 2016, five days after the death of the last baby Letby was convicted of murdering or attempting to murder.

He told the inquiry he was unaware of Letby’s name at the time, but while the concerns were “very shocking to hear”, the trust “wouldn’t jump to criminality as a causal factor”.

He appeared to be unclear in his evidence whether he was aware at that point of allegations Letby had deliberately harmed the babies. 

Mr Chambers said: “What I was hearing was that there were concerns being raised. There was some hypothesis of what those causes of harm might be and there was a suggestion that there was a member of staff who was on duty more times than other staff.”

However, he said from other staff, “there was strong rebuttal to the proposition that this was one nurse deliberately causing harm… there was a very strong level of support for this individual”.

The police were not called until nearly a year later, during which time the trust ordered several reviews.

The inquiry session in Liverpool heard that trust leaders decided to involve police following a meeting in March 2017, but Mr Chambers did not write to Cheshire Police’s chief constable until 2 May that year.

The former CoCH chief stressed “there was never any intention not to go to the police” but said he wanted to be sure how the trust would manage that next step.

At the outset of his evidence, Mr Chambers offered his condolences to the families whose babies were killed and harmed and said: “I cannot imagine the impact this has had on your lives, and I am truly sorry for the pain that may be prolonged by any decisions or actions that I took in good faith.”

‘Threatening guns to my head’

Inquiry counsel Nicholas de la Poer KC questioned Mr Chambers about a meeting Letby and her parents had with the trust in December 2016.

This followed the nurse being moved off the neonatal unit in summer 2016, to work elsewhere in the hospital, in response to pressure from medical consultants.

She had raised a grievance complaint about this, which the trust explored and upheld. Mr Chambers was recorded at the meeting as telling her she would go back to work on the neonatal unit, after a grievance complaint about her being taken off the staffing rota. Mr Chambers was understood to have told her: “Lucy, don’t worry, we’ve got your back.”

While he admitted the phrasing was “clumsy”, he added: “I’m prepared to accept we had not been open and honest with [Letby]. Letby’s father was very unhappy.

“He was making threats that would have just made an already difficult situation even worse by threatening [General Medical Council] referrals, threatening guns to my head and all sorts of things.”

Mr De la Poer KC said executives felt Letby should be allowed to return to the neonatal unit in February 2017. He asked Mr Chambers whether he was not listening to hospital consultants’ concerns at this point, which he denied.

He said: “We’d been given really strong messages from [a review commissioned from the Royal College of Paediatrics and Child Health] that the unit was calmer, the unit felt safer.” He said at that point there was “nothing pointing towards unnatural causes”.

Mr Chambers stepped down from CoCH in autumn 2018. The inquiry has heard he had fallen out with non-executive board members, as well as a potential vote of no confidence by medical consultants.

He told the inquiry he wanted to serve six months’ notice, but recognised a vote of no confidence would not have helped the organisation. Shortly after this point, NHS Improvement organised for him to be moved into another non-CEO role.

NHSI’s then regional director last week told the inquiry she was tasked by its CEO, Ian Dalton, with finding him a temporary role. It appears he was moved to a non-CEO role at the Northern Care Alliance, before later becoming interim CEO of three trusts.

Peter Skelton KC, who represents a group of families, asked about a statement to the inquiry from NHS England which said they were not aware about potential criminal conduct at the time of concerns being raised.

Mr Chambers said concerns were raised around increased mortality around 2017, but not a link to Letby.

Asked if he should have told NHSE sooner about concerns about her, he said, “I don’t know,” and added: “It’s just a balance between duty of candour and duty of care. Whether we got that balance wrong, I don’t know.”

Mr Chambers is due to give further evidence on Thursday.