Failures to deal with complaints about Lucy Letby “more likely than not” led to the deaths of babies, the former boss of a hospital where the killings occurred has said.

Letby, 33, was sentenced to a whole-life term on Monday for the murder of seven babies and the attempted murders of six more.

Dr Susan Gilby, who took over as the Countess of Chester Hospital’s medical director a month after Letby was arrested in 2018, said victims’ families were treated in an “appalling” way by executives.

Senior doctors at the hospital, where the nurse carried out her year-long killing spree on the neonatal unit, raised concerns for months before she was finally taken off frontline duties.

Dr Gilby told Sky News there was “certainly a possibility” that management failures to deal with complaints led to lives being needlessly lost.

She added: “But it needs to be an external and objective review, looking at all the evidence, and giving people the right of reply to that evidence, that will come to that conclusion, and not for individuals such as myself.

“From a personal point of view, and obviously speaking more as a mother than a doctor or a senior leader in the NHS, it’s my greatest fear and I think it’s more likely than not that that will turn out to be the case.

“I sincerely hope that it isn’t.”

The hospital saw a significant rise in the number of babies suffering serious and unexpected collapses in 2015 and 2016.

Letby’s presence when collapses took place was first mentioned to senior management by the unit’s head consultant in late June 2015.

Concerns among some consultants about Letby increased and were voiced to hospital bosses when more unexplained and unusual collapses followed, her trial at Manchester Crown Court heard.

But Letby was not removed from the unit until after the deaths of two triplet boys and the collapse of another baby boy on three successive days in June 2016.

She was confined to clerical work but registered a grievance procedure, which was resolved in her favour, and was due to return to the unit in March 2017.

The move did not take place as soon after police were contacted by the hospital trust.

Parents of babies have claimed they received a “total fob off” from hospital medical director Ian Harvey after raising concerns, a lawyer representing them said.

Dr Gilby told the Guardian: “There may be correspondence with the families that I’ve not been party to, but what I have seen was appalling.”

In a statement to the same newspaper, Mr Harvey said: “Having read the heart-rending victim impact statements, I know how desperate the parents are for answers and I will help them as best I can at the inquiry.

“I’m sorry they felt fobbed off. I wanted to give detailed and accurate answers, but this was difficult while the reviews and investigations were taking place. Once the police were involved, we were advised by them not to say or do anything that might jeopardise their investigation.”