Child abuse fatalities and cases of extreme concern: lessons from reviews

Abstract

Objective: The study was commissioned by the Welsh Office to pull together lessons from all reports on cases involving either a child abuse fatality or serious child protection concern (“Part 8 Reviews”) since the introduction of the Children Act 1989. Method: Twenty-one such reports were identified and subjected to a content analysis to extract practice issues. Results: From 19 reports (excluding Reviews concerning adult sexual abusers), the authors identify seven practice themes emerging from that analysis which are related to those identified in previous studies and to six previously undertaken British overviews of child abuse fatalities. The themes are assessment, interagency communications, responsibility, number of professionals involved, role of general practitioners, insufficient training for pediatricians/radiologists, and parental choice. Conclusions: British child protection agencies are attempting to address apparently conflicting policy objectives. On the one hand they are required to ensure the protection of the most vulnerable children within the child protection system. At the same time they are also being encouraged to adopt a “lighter touch” in child protection work. The authors conclude that the seven themes may provide some indicators as to how these conflicting objectives may be reconciled.