G26(P) Rapid response to unexpected death; a service improved, a countywide approach

Abstract

Local safeguarding children boards (LSCB) are responsible for putting in place procedures for ensuring that there is a co-ordinated response by the authority, their board partners, and other relevant persons to an unexpected death. A rapid response by a group of key professionals who come together for the purpose of enquiring into and evaluating the unexpected death of each child is set out in Rapid Respnse procedures in chapter 5 of Working Together 2015. Essex County has 3 LSCBs; Southend, Essex and Thurrock (SET). Up until early 2015 there were 5 rapid response teams, which represented 5 local District General Hospitals, within SET. The teams were reporting to 5 respective Local Child Death Overview Panels (LCDOP) and one Strategic Child Death Overview Panel (SCDOP). There was huge variation in support to families and discrepancies around quality of the rapid response process. There was limited scope for individual rapid response practitioners to develop an expertise thus impacting on the family’s experience. Different models of rapid response in the county had significant cost implications for Clinical Commissioning Groups (CCG). A team of three dedicated Rapid Response Practitioners were commissioned by 7 CCG’s to deliver the service over 1400 Square miles. Three months mobilisation of the new service enabled a Standard Operating Procedure to be implemented at 5 District General Hospitals. The team, over 18 months, attended 60 rapid responses including home visits, multi-agency meetings, family de-brief of post-mortems, final case discussions and review at panel whil providing bereavement support and signposting to families. The team delivered training and networking opportunities to 1300 personnel in 26 organisations. The dedicated team enables longstanding individualised support to bereaved families. Practitioners have developed an expertise in critically reviewing deaths contributing to identified learning. Changes have enhanced collaborative multi-agency working with consequent improvement in quality of the entire Child Death Review process within SET and is very cost effective. Adoption of a similar approach in other counties could confer significant benefit to the local child death review process.