The villains: Managers and senior staff criticised over their inaction that left killer on the wards

Several managers and senior staff at the Countess of Chester Hospital were singled out in the Thirlwall Inquiry's report into how Lucy Letby was free to kill.Colleagues were quick to believe Letby, and dismissed fears from doctors that she was to blame for the spike in baby deaths. The inquiry found medical director Ian Harvey failed to consider whether steps had been taken to safeguard babies.He told the inquiry he 'sincerely regretted' not calling in police sooner when evidence pointed to Letby but claimed the consultants failed to show him 'anything (that) took it over the bar' for detectives to be drafted in.'It was never raised as something had been seen, something had been done,' he said. 'It was raised as there is an increase in the number of deaths but we don't understand why.'The retired orthopaedic surgeon, who was paid £175,000-a-year, insisted he took concerns seriously when raised by consultants working with Letby. The Countess's former medical director Ian Harvey arrives to give evidence at the inquiry Alison Kelly, the former director of nursing at the Chester hospital, arrives at the Thirlwall Inquiry at Liverpool Town Hall last yearLady Justice Thirlwall wrote: 'He had a duty to consider whether steps should be taken to safeguard other babies on the unit. He failed to do so.'His colleague Alison Kelly, the £130,000-a-year director of nursing, admitted to the inquiry that she 'missed an opportunity' to keep babies safe.She denied concealing the spike in mortality from inspectors from the Care Quality Commission or being slow to respond to concerns about Letby.However, she accepted she should have been 'more attentive' and 'it (the spike) could have been looked at in a more timely way'.She claimed other staff should have 'picked up the phone' because her workload was 'very large' which meant she often missed emails. But she denied being 'too busy to do her job'.Significantly, despite being the hospital's safeguarding lead, she never flagged the consultants' concerns to the local safeguarding board, or local safeguarding officer, or NHS England.If they had been, she admitted, Cheshire Constabulary would have been notified and Letby likely suspended earlier.The report rejected her denials to the inquiry that there was animosity between doctors and nurses. Karen Rees former head of care nursing at the Countess of Chester Hospital, and Letby's senior managerLetby had an ally in Tony Chambers, the Countess of Chester Hospital's £160,000 chief executive.Himself a former nurse, he told the inquiry he sided with Letby after doctors raised concerns she was killing babies because she won her employment grievance against the Trust.Mr Chambers denied stalling the police investigation for ten months to protect the reputation of himself and the hospital.Several of the medics described Mr Chambers as being dictatorial and aggressive.The report found he 'never once scrutinised his own thought processes', and 'lost objectivity and made poor decisions'.Letby also found loyalty in Eirian Powell, the head of the neonatal unit.But as babies began dying, and the weight of evidence against Letby began to build, Ms Powell said there was no proof the nurse was to blame.She insisted no one saw Letby do anything – and even as late as May 2016 was 'vociferous' in her support for her to remain on the ward.She admitted that 'with hindsight' the police should have been called and she failed in her responsibilities to protect babies on the unit from harm.The report found Ms Powell's judgment was likely 'affected by her view that Letby was a very good nurse (she was later to describe her as the 'creme de la crème') and that she was always available for extra shifts'.The report found it was 'ridiculous' that Karen Rees, director of nursing care, baselessly believed a neonatal consultant and Letby had previously been in a relationship, prompting his request for her to be removed from the ward.The report said: 'That Ms Rees was comfortable making such an extreme allegation against a paediatrician without any basis demonstrates that she had lost all judgement in the face of what she had been told.'The report accepted that Ms Rees, Ms Kelly and Ms Powell initially believed that Letby was not responsible for the spike in baby deaths.But it added: 'Loyalty seems to have prevented them from considering the doctors' concerns with an open mind or thinking about safeguarding.'