A nurse tried to murder a baby just a day after a hospital executive refused to remove her from her duties despite staff concerns, a court has heard.

Lucy Letby denies murdering seven babies and attempting to murder 10 others on the neo-natal unit of the Countess of Chester Hospital between June 2015 and June 2016.

Prosecutors claim she tried to kill her 17th and final victim – referred to as Child Q – by injecting him with air during a day shift on Saturday 25 June 2016.

At Manchester Crown Court on Tuesday, senior paediatrician Dr Stephen Brearey said the day before that incident he had told nursing chief, Karen Rees, that he and his consultant colleagues were “not happy” with Letby continuing to work on the unit.

Dr Brearey told the trial: “She (Ms Rees) was familiar with our concerns already. I explained what had happened and I didn’t want nurse Letby to come back to work the following day or until this was all investigated properly.

“Karen Rees said ‘no’ to that and that there was no evidence.

“I put it to her – was she happy to take responsibility for this decision, in view of the fact that myself and my consultant colleagues all wouldn’t be happy with nurse Letby going to work the following day?

“She responded she was happy to take that responsibility.”

Dr Brearey also said that, prior to that conversation, he had held a debrief with staff members, including Letby, following the deaths of two brothers – referred to in court as Child O and Child P.

The nurse is accused of murdering Child O on Thursday 23 June 2016 and Child P on Friday 24 June 2016.

Dr Brearey told the trial that Letby “didn’t seem overly upset in the debrief, or upset at all, and she told me she was on shift the next day, which was a Saturday.”

He added: “I was concerned about this because we had already expressed our concerns to senior management about the association with nurse Letby and the deaths we had seen on the unit.”

‘It can’t be Lucy, not nice Lucy’

In June 2015, Dr Brearey carried out a review into the circumstances of the death of another infant – referred to as Child D – which had happened that month.

The court heard that an “association” with Letby and her presence at a number of collapses up to that point were noted.

Dr Brearey told the court there was then a meeting with director of nursing, Alison Kelly, in late June or early July 2015.

He said: “I think my comment at the time during the meeting was ‘it can’t be Lucy, not nice Lucy’.”

Ben Myers KC, defending Letby, said: “I would suggest that once Ms Letby had been identified as someone, or a factor, that caused concern there was naturally a bias against her in the way she behaved and the way it was interpreted, do you agree?”

Dr Brearey replied: “I disagree.”

There was a further review of collapses at the unit by a neonatologist from Liverpool Women’s Hospital in February 2016, the court was told.

Dr Brearey said he sent a report of those findings to the director of nursing and the hospital’s medical director as he asked for another meeting.

There was no formal complaint to police during this period, he confirmed.

The paediatrician said he wanted to “escalate” concerns within the hospital management rather than go directly to the police. He said: “I needed executive support and that was what we were after.”

Dr Brearey added there were “no more events” after Letby, originally from Hereford, left the neo-natal unit.

He said: “It was the same staff doing the same job and there were no sudden collapses.”

The trial continues.