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Serious Case Reviews

A serious case review (SCR) takes place after a child dies or is seriously injured and abuse or neglect is thought to be involved. It looks at lessons than can help prevent similar incidents from happening in the future.

A SCR should take place if abuse or neglect is known, or suspected, to have been involved and

  • a child has died
  • or a child has been seriously harmed and there is cause for concern about how organisations or professionals worked together to safeguard the child


  • the child dies in custody
  • or a child died by suspected suicide.


What is seriously harmed and how is it determined

Seriously harmed includes, but is not limited to, cases where the child has sustained, as a result of abuse or neglect, any or all of the following:

  • a potentially life-threatening injury;
  • serious and/or likely long-term impairment of physical or mental health or physical, intellectual, emotional, social or behavioural development.


This definition is not exhaustive. LSCBs should use available research evidence when considering whether serious harm has occurred.

Source: HM Government (2015) Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children (PDF). [London]: Department for Education (DfE).
The purpose of a SCR is to establish whether there are lessons to be learnt from the case about the way in which local professionals and organisations work together to safeguard and promote the welfare of children. Dudley Safeguarding Children Board (DSCB) has also been committed to undertaking smaller scale partnership reviews for instances where the case does not meet the criteria for a serious case review but it is considered that there are lessons for multi-agency working to be learnt.

The DSCB will determine the terms of reference; appoint an independent reviewer; involve the young people and their families, as well as practitioners; agree recommendations, action plans and the final report. Each agency contributing to a case review is required to produce an action plan to ensure they meet the recommendations made for their agency. Progress on these actions is monitored and reported to the DSCB SCR subgroup with oversight of quality assurance.

The DSCB values the perspective of families involved.

For any professionals a referral should come to the Serious Case Review Sub-group. For information please contact the DSCB Business Unit on 01384 813067 or dscb@dudley.gov.uk