Key References and Links

The following links present relevant general and specific UK references which outline good practice and guidance about safeguarding children as well as the relevant UK children’s legal framework.

 

Key issues for Child Death Overview Process (CDOP) as a result of proposed changes to Working Together published October 2018 (NB: these changes apply to England only)

 

Overarching changes:

  • Political responsibility for child death review will move from DfE to DH
  • Local responsibility for review rests with the local authority and CCGs
  • A National child death mortality database to be established to collate national data has begun work. Expected implementation 2020
  • Revised guidelines (WT 2018) published autumn 2018 set out the responsibility of child death review partners
  • Revised forms for information gathering and analysis issued in autumn 2018. These are now called:
    • Notification form (previously known as form A)
    • Reporting form (previously known as Form B)
    • Analysis form (previously known as Form c).  From 2020 this information will be shared with the national child mortality database. Currently data is sent to NHS digital.
  • Revised guide for families also due to be published.

 

Joint agency response:

This is a co-ordinated multi-agency response which will be triggered if the death:

  • Is or could be due to external causes
  • Is sudden and no apparent cause (including SUDI/C)
  • Occurs in custody, or where child detained under Mental Health Act
  • Initial circumstances raise suspicions that death may not have been natural
  • Still birth where no health care professional in attendance

 

Aim of child death review is to:

Identify cause of death

  • Provide support to families
  • Identify modifiable/contributory factors
  • Ensure statutory obligations are met
  • Learn lessons. Promote health and wellbeing of other children.

 

Changes to process of child death review

All deaths in children should follow a similar path to include:

  • Immediate decision making and notifications to include decision as to whether needs joint agency response (involve Rapid response team to aid information gathering for unexpected death)
  • Investigation and information gathering

Child death review meeting needs to be flexible and proportionate but be held for all child deaths not just unexpected deaths

  • CDOP (Child Death Overview Process)
  • National child mortality database
  • Support for families - Families should have an identified key worker to act as named point of contact throughout the process of the child death review.
     

NICE Guidelines

Guideline (NG55) 2016 - Harmful sexual behaviour among children and young people
This guideline covers children and young people who display harmful sexual behaviour, including those on remand or serving community or custodial sentences. It aims to ensure these problems don’t escalate and possibly lead to them being charged with a sexual offence. It also aims to ensure no one is unnecessarily referred to specialist services.

Guideline (NG76) 2017 - Child abuse and neglect
This guideline covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.

Clinical features of abuse and neglect (including physical injury) are covered in NICE’s guideline on child maltreatment. Recommendations relevant to both health and social care practitioners appear in both guidelines.


UK law (England, Wales, Northern Ireland):

UK law (Scotland):


Additional guidance is available from other sections of our site, please see::


Other useful sources of information

The NHS England Safeguarding webpages provide additional excellent links and contacts with additional pages on topics not covered in these web pages, e.g. modern slavery.

Patterns of bruising in preschool children—a longitudinal study
Kemp AM, et al. Arch Dis Child 2015;0:1–6. doi:10.1136/archdischild-2014-307120*

What this study says:
Bruising affects a small proportion of babies who cannot roll over.

  • Rare sites for bruising: ears, neck, genitalia, hands, in any child and buttocks and front trunk in early and premobile children.
  • Nine per cent of children have twice as many bruises as would be expected for their developmental stage.

Female Genital Mutilation (FGM)
You may also find the following article useful on FGM, it is not open access but anyone with an OpenAthens account can view it for free:
Weston J Female genital mutilation: the law as it relates to children Archives of Disease in Childhood 2017;102:864-867.

Virtual Case – FGM (PowerPoint)


Sudden Unexpected Deaths in Infancy (SUDI)

Following three high profile criminal cases involving prosecution of mothers for the death of their child(ren) an intercollegiate (RCPath/RCPCH) working party produced a protocol for handling sudden unexpected death in infants (SUDI) in 2003. This has recently been revised (November 2016). It has been extended to include all deaths in infancy and childhood. 

Sudden unexpected death in infancy and childhood: Multi-agency guidelines for care and investigation, Royal College of Pathologists, 2016. 

(Please note that this protocol is for England and does not describe the process for Scotland and Wales).

 

You may also find it useful to refer to the resources in our Educational Resources section.


*This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.