The Thirlwall Inquiry's report into the Lucy Letby case has singled out several senior managers and staff at the Countess of Chester Hospital for failing to act on repeated warnings from doctors that the nurse was harming babies. The inquiry found that trust between colleagues and misplaced loyalty to Letby led figures in senior leadership to dismiss consultants' concerns, delaying police involvement and allowing her to remain on the neonatal unit for months longer than she should have.

Medical director Ian Harvey, paid £175,000 a year, said he "sincerely regretted" not calling police sooner but was found by Lady Justice Thirlwall to have failed in his duty to safeguard babies. Director of nursing Alison Kelly, on £130,000, admitted she "missed an opportunity" to protect babies but never escalated concerns to the safeguarding board or NHS England. Chief executive Tony Chambers, on £160,000, was accused of siding with Letby and losing objectivity, while head of nursing Karen Rees and neonatal unit head Eirian Powell were criticised for their unwavering faith in Letby, whom Rees once called the "creme de la creme".