‘Discredited’ serious case review model to be scrapped

The government will overhaul the way child deaths are investigated after an independent review found the Serious Case Review process was “discredited” and unfit for purpose.

Under the current system, Local Safeguarding Children’s Boards are required to undertake Serious Case Reviews when a child dies or is seriously injured and abuse or neglect is thought to be involved.

The government will replace this locally-commissioned system with a new centralised framework based on a mixture of national and local reviews. Ministers believe the new system will bring greater consistency, speed and quality to investigations.

A national independent body will be set up to oversee the framework, which will introduce a tiered approach to investigations. The vast majority of deaths or incidents will be investigated using rapid “local learning inquiries”. However, the national body will also have the ability to commission and carry out “national serious case inquiries”.

The government’s announcement came in response to a review of local safeguarding children’s boards, which was carried out by former president of the Association of Directors of Children’s Services Alan Wood.

Wood’s review concluded a “fundamental change” was needed in the way deaths were investigated.

“Despite guidance to the contrary, the model of serious case reviews has not been able to overcome the suspicion that its main purpose is to find someone to blame. Although there has been some improvement in the quality of some reviews the general picture is not good enough and the lessons to be learned tend to be predictable, banal and repetitive,” he wrote.

The new system should provide a more proportionate response focused on learning, Wood said. He estimated national serious case inquiries would apply to around 20 cases a year, compared to the 101 serious case reviews that were carried out in 2014-15.

Wood said the remit of the independent body, including the criteria for national inquiries, should be subject to consultation “to ensure national support for the framework”. The new organisation should be accountable to the government, he recommended.

Following Wood’s review the government also said it will introduce a new statutory framework that effectively removes the requirement for areas to have local safeguarding children’s boards.

The government will instead introduce a duty for three partners – councils, the police and the NHS – to set up multi-agency child protection arrangements. The move is a response to concerns in Wood’s review that safeguarding boards currently had large and “unwieldy” memberships.

David Jones, chair of the association of independent safeguarding board chairs, said the government’s proposals represented “the biggest shake up in safeguarding children arrangements since the 1970s”.

“The big challenge for government and for local partnerships will be sustaining an essential focus on today’s child protection challenges whilst sorting out tomorrow’s structures. This will be a two or three year change process with all the inherent risks that implies. Independent LSCB chairs will do our best to sustain essential arrangements whilst supporting transition,” he said.

A Department for Education spokesperson said: “We are committed to doing all we can to protect children. We are grateful to Alan Wood for his insightful report, and welcome his recommendations.

“That is why our new Children and Social Work Bill already sets out provisions to set up a new Panel to manage a centralised process, which will help to resolve long-term issues of quality, timeliness and dissemination of national lessons, and why we will put in place measures to improve multiagency working, as recommended.”