Before his arrest in 1998 none of his patients suspected Harold Shipman was anything other than he appeared - a kindly, caring GP devoted to his practice.

Only after he clumsily forged the £386,000 will of his last victim, 81-year-old Kathleen Grundy, did police start to uncover the horrific death toll that stunned the town of Hyde in Greater Manchester.

Shipman, now 56, was convicted at Preston Crown Court in January 2000 of the murders of 15 of his elderly women patients over a three-year period in the 1990s.

But only with the publication yesterday of the first report of Dame Janet Smith's independent inquiry into his crimes did the full extent of his murderous career become clear.

Shipman killed his victims with injections of the painkiller diamorphine - the clinical name for heroin.

He had stockpiled vast amounts of the drug by using false prescriptions.

After his arrest, police found enough diamorphine for 1,500 fatal doses hoarded in his home in Mottram-in-Longendale, Tameside.

The doctor's abuse of the drugs prescription system began at the start of his career in 1974 when he joined the Abraham Ormerod Medical Centre in Todmorden, West Yorkshire.

He became addicted to the painkiller pethidine and had to undergo psychiatric treatment after being convicted at Halifax Magistrates' Court in 1976 of unlawful possession and forgery.

He then worked as a clinical medical officer in County Durham before joining the Donneybrook House group practice in Hyde.

His killing spree began in earnest when he set up his single-handed practice at The Surgery in Hyde's Market Street in 1992.

He would usually call on his mainly elderly victims at their homes, often on a pretext, and dispense his deadly injections.

In a surprising number of cases, Shipman admitted to being present when his patients died or claimed to have discovered the body and would dismiss in front of relatives the need for a post-mortem examination.

Back at his surgery, he would falsify his computer records to create bogus symptoms that would explain his victims' deaths.

In March 1998, a member of staff at an undertakers and another GP in Hyde became alarmed at the death rate among Shipman's patients.

South Manchester Coroner John Pollard called in Greater Manchester Police.

But an investigation found nothing untoward. Shipman went on to claim more lives.

Jailing the family GP for life, trial judge Mr Justice Forbes told him that the sheer wickedness of what he had done was "shocking beyond belief".

"For your own evil purpose you took advantage of and grossly abused the trust each victim put in you," he said.

"I have little doubt each one smiled and thanked you as she submitted to your fearful ministrations. You have not shown the slightest remorse."

Shipman's wife, Primrose, 52, gave evidence to the inquiry hearings in Manchester Town Hall, but said that she could remember little or nothing of incidents surrounding the suspicious deaths of patients.

After the trial, the coroner held inquests on another 27 suspected victims of Shipman. He ruled that 25 had been unlawfully killed and returned two open verdicts.

Earlier this month, Home Secretary David Blunkett ruled that Shipman, held in Frankland jail, County Durham, should serve a "whole life" tariff, a ruling that effectively means he will die behind bars.