Developing effective child death review: a study of 'early starter' child death overview panels in England.

AIM: This qualitative study of a small number of child death overview panels aimed to observe and describe their experience in implementing new child death review processes, and making prevention recommendations. METHODS: Nine sites reflecting a geographic and demographic spread were selected from Local Safeguarding Children Boards across England. Data were collected through a combination of questionnaires, interviews, structured observations, and evaluation of documents. Data were subjected to qualitative analysis. RESULTS: Data analysis revealed a number of themes within two overarching domains: the systems and structures in place to support the process; and the process and function of the panels. The data emphasised the importance of child death review being a multidisciplinary process involving senior professionals; that the process was resource and time intensive; that effective review requires both quantitative and qualitative information, and is best achieved through a structured analytic framework; and that the focus should be on learning lessons, not on trying to apportion blame. In 17 of the 24 cases discussed by the panels, issues were raised that may have indicated preventable factors. A number of examples of recommendations relating to injury prevention were observed including public awareness campaigns, community safety initiatives, training of professionals, development of protocols, and lobbying of politicians. CONCLUSIONS: The results of this study have helped to inform the subsequent establishment of child death overview panels across England. To operate effectively, panels need a clear remit and purpose, robust structures and processes, and committed personnel. A multi-agency approach contributes to a broader understanding of and response to children's deaths.

Collaboration, integration and change in children's services: critical issues and key ingredients.

BACKGROUND: Government and state policy, irrespective of jurisdiction, increasingly require and indeed specify the nature of collaboration with regard to the delivery of child welfare services for maltreated children. The rationale for collaboration appears obvious in as much as it is aimed at promoting multidisciplinary practice in order to meet the needs of the vulnerable child. However, collaboration, whilst a useful and motivating concept, is in reality far from straightforward and contains complexities and ambiguities. AIM: The aim of this paper is to explore these complexities and ambiguities to provide an overview of key developmental frameworks relevant to the creation and maintenance of strategic high-level multiagency partnerships. COMMENTARY: The authors begin by exploring the characteristic features of different levels of multiagency collaboration that is communication, co-operation, co-ordination, coalition, and integration. As the emphasis in a variety of jurisdictions in the Western world is on the highest levels of collaboration namely coalition and service integration this is the focus of the paper. The authors synthesize the main literature in the field to consider the critical elements for effective collaborative endeavors at this level including predisposing factors, mandate, leadership, machinery, process, and outcomes. The paper concludes by recognizing that the drive towards integrated services is occurring in a climate of continuing change. The need to identify the impact of such an environment when managing multiagency partnerships is explored using five steps to change.