Responding to unexpected infant deaths: experience in one English region.
OBJECTIVE
New national procedures for responding to the unexpected death of a child in England require a joint agency approach to investigate each death and support the bereaved family. As part of a wider population-based study of sudden unexpected deaths in infancy (SUDI) we evaluated the implementation of this approach.


METHODS
A process evaluation was carried out using a population-based study of all unexpected deaths from birth to 2 years in the South West of England between January 2003 and December 2006. Local police and health professionals followed a standardised approach to the investigation of each death, supported by the research team set up to facilitate this joint approach as well as collect data for a wider research project.


RESULTS
We were notified of 155/157 SUDI, with a median time to notification of 2 h. Initial multi-agency discussions took place in 93.5% of cases. A joint home visit by police officers with health professionals was carried out in 117 cases, 75% within 24 h of the death. Time to notification and interview reduced during the 4 years of the study. Autopsies were conducted on all cases, the median time to autopsy being 3 days. At the conclusion of the investigation, a local multi-agency case discussion was held in 88% of cases. The median time for the whole process (including family support) was 5 months.


CONCLUSIONS
This study has demonstrated that with appropriate protocols and support, the joint agency approach to the investigation of unexpected infant deaths can be successfully implemented.
Sidebotham
Peter
P
Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. p.sidebotham@warwick.ac.uk
Blair
Peter S
PS
Evason-Coombe
Carol
C
Edmond
Margaret
M
Heckstall-Smith
Ellen
E
Fleming
Peter
P
D001344:Autopsy; D002662:Child Health Services / Q000458:organization & administration*; D004739:England / Q000453:epidemiology; D019983:Guideline Adherence; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007373:Interinstitutional Relations; D016495:Police / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D013398:Sudden Infant Death / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors