The NMC was first contacted by the Countess of Chester Hospital in July 2016 and informed about a rise in mortality of babies but told that no evidence of medical incompetence had been found, though “some clinicians” were concerned Letby may present a serious risk to public safety.

Counsel to the inquiry Nicholas de la Poer KC asked Ms Herniman if there was “a concerted effort to identify exactly who it was (who) had concerns” about Letby.

He added: “We know the truthful answer would have been the head of the neonatal unit, the lead consultant for children’s services and all five consultant colleagues, which adds quite a lot of colour and potential potency to simply ‘some clinicians’, do you agree?”

Ms Herniman said: “Agreed, which is why it is the position of the NMC that we should have shown more curiosity at this stage.”

Letby remained free to work without any restrictions imposed by the NMC until she was charged in November 2020.

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