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Learning from serious case reviews : report of a research study on the methods of learning lessons nationally from serious case reviews

Department for Education
Publication Date
  • R Medicine (General)


The death of a child from abuse or neglect is of huge public and professional importance. In recognition of this, in England, every such death is subject to a multi-agency Serious Case Review. The purpose of these reviews is to establish whether there are lessons to be learned from the case with regards to the way in which local professionals and organisations work together to safeguard and promote the welfare of children. The overall aim of this project was to undertake a scoping exercise to inform the development of a revised framework for conducting national reviews. It aims to critically appraise the approaches to analysis developed and used in the previous biennial reviews, along with the more recent Ofsted reviews, in order to assess their utility in identifying common themes and trends and in auditing the process and outcomes of Serious Case Reviews. It also aims to ascertain the views of those carrying out Serious Case Reviews, and a wider representative group of practitioners and policy makers, on the validity and usefulness of Serious Case Reviews, the biennial reviews, and the proposed new systems for conducting national reviews.

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