They said neonatal unit manager Eirian Powell was also “firmly of the view that Letby was a good and competent nurse”.

The inquiry heard Mr Chambers, Ms Kelly, Mr Harvey and Ms Hodkinson had worked in healthcare for many years but had “never come across such criminal behaviour”.

“That a nurse could be responsible for these heinous crimes is profoundly disturbing,” Ms Blackwell said.

“It is not something that any of us ever expected to be happening on the neonatal ward of the hospital, it being so against the natural order of what was contemplated or foreseen.”

The inquiry also heard an opening statement on behalf of NHS England, which criticised the Countess of Chester Hospital for under-reporting serious incidents in its neonatal unit.

Jason Beer KC, on behalf of NHS England, told the inquiry: “It seems to be generally acknowledged that there was under-reporting of incidents on the neonatal unit.”

Mr Beer said NHS England acknowledged it “could have done more” to scrutinise the hospital when death rates on the unit became a concern.

Letby, from Hereford, is serving 15 whole-life prison terms after she was convicted in August 2023 of murdering seven babies and attempting to murder seven others between June 2015 and June 2016.

The inquiry continues.

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