Three babies might have survived and seven others could have been protected if hospital bosses and doctors had taken action over concerns about the nurse Lucy Letby, the Thirlwall inquiry found. This was reported by Qazaqyia.kz citing The Guardian.
The report found a "complete failure" in safeguarding to protect babies on the neonatal unit at the Countess of Chester hospital, where Letby worked.
The inquiry, which was chaired by Lady Justice Thirlwall, also found parents were "kept in the dark" for years about what happened to their babies and the concerns they may have been deliberately harmed.
Thirlwall said the report described dysfunctional management and governance, a gulf between hospital leadership and clinicians, and failure to understand the fundamentals of safeguarding.
A total of 14 recommendations were made in the report, including the fitting of baby monitors in all cots and incubators in neonatal units and CCTV cameras focused on insulin storage fridges.
But the inquiry chair said she was not reassured that ministers would act on her recommendations after the abolition of NHS England and little clarity on which body would take responsibility.
The health secretary, Yvette Cooper, is due to make an oral statement on the inquiry's findings at 3pm.
Letby, who maintains her innocence, is serving 15 whole-life terms for the murders of seven babies and attempted murders of seven others by various means between June 2015 and June 2016. The 36-year-old was twice denied permission to appeal against her convictions in 2024.
The Criminal Cases Review Commission is considering evidence presented on her behalf by an international panel of medics who claim poor medical care and natural causes were the reasons for the babies collapsing.