Lucy Letby was not referred to the nursing regulator after concerns about her were raised to hospital bosses because there was a “lack of evidence” she may be killing babies, a public inquiry has heard.
Doctors on the neonatal unit at the Countess of Chester Hospital had raised their concerns in June 2016 after the deaths of two triplet boys.
The Thirlwall Inquiry heard the director of nursing had phoned a Nursing and Midwifery Council (NMC) employer link representative, Tony Newman, on 6 July 2016.
Mr Newman told the hearing that Alison Kelly had told him there was a rise in mortality of babies but she did not say a nurse was suspected of deliberately harming babies.
The inquiry, at Liverpool Town Hall, is examining the events surrounding the serial killer’s crimes.
It has previously heard that senior managers opted to commission a series of reviews into the increase of baby deaths on the neonatal unit instead of calling the police.
Mr Newman told the inquiry Ms Kelly had highlighted the increase in baby deaths on the neonatal unit and said they had not detected any medical incompetence.
She said one registrant had been present at nearly all the incidents, he said.
The inquiry heard she had told him some clinicians were concerned the registrant may present a serious risk to public safety, although no evidence was available.
Mr Newman said he advised Ms Kelly that the health trust should carry out its own “local” investigation and told her that there was “no allegation and no evidence” to support a fitness to practise referral for Letby.
He added: “There was no allegation made on the call. Alison never said to me, ‘we suspect she could be deliberately harming babies’.
“Had she said that it would have set off all sorts of alarm bells and we probably would have said, even with a lack of evidence, we would have recommended a referral at the time so we could contact the police.
“The key aspect of the Nursing and Midwifery Council is to protect the public but in order to do that we need clear information and evidence to restrict someone’s practice.”
Letby is serving 15 whole-life terms after being convicted of murdering seven babies and attempting to kill seven others, between June 2015 and June 2016, with two attempts on one of her victims.
After her convictions, Letby, 34, originally from Hereford, was stripped of her nursing credentials and struck off the register at an NMC fitness to practise hearing in December 2023.
The inquiry will resume in January when it will hear its final two weeks of evidence, with findings expected to be published in autumn 2025.