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

Objective: The study was commissioned by the Welsh Office to pull together lessons from all reports on cases involving either a child abuse fatality o r serious child protection concern ("Part 8 Reviews") since the introductio n 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 w hich are related to those identified in previous studies and to six previou sly undertaken British overviews of child abuse fatalities. The themes are assessment, interagency communications, responsibility, number of professio nals involved, role of general practitioners, insufficient training for ped iatricians/radiologists, and parental choice. Conclusions: British child protection agencies are attempting to address ap parently conflicting policy objectives. On the one hand they are required t o ensure the protection of the most vulnerable children within the child pr otection system. At the same time they are also being encouraged to adopt a "lighter touch" in child protection work. The authors conclude that the se ven themes may provide some indicators as to how these conflicting objectiv es may be reconciled. (C) 1999 Elsevier Science Ltd.