Publication - Advice and guidance

Child Death Reviews: Scottish Government Steering Group Report

Published: 18 Mar 2016
Part of:
Health and social care
ISBN:
9781786521170

The report of the Scottish Government Child Death Reviews Steering Group setting out recommendations for establishing a national child death review system in Scotland.

61 page PDF

1.0 MB

61 page PDF

1.0 MB

Contents
Child Death Reviews: Scottish Government Steering Group Report
Annex 3

61 page PDF

1.0 MB

Annex 3

NOTIFICATION AND DATA COLLECTION FORMS

Data items for Child Death Review forms Form 1 Form 2 Form 3
Data item Coding structure/comments Initial notification Information gathering template Summary review output data
Child identifiers and demographics
CDR unique case reference number
CHI number
NRS death registration identifiers
NRS registration district
NRS registration year
NRS entry number
First forename
Second forename
Surname
Previous forename
Previous surname
Date of birth DD/MM/YYYY
Gender M/F
Address of usual residence
Postcode of usual residence
Alternative postcode Eg if child lives between two homes or has recently moved
Country of residence
Area of usual residence NHS Ayrshire & Arran
NHS Borders
NHS Dumfries & Galloway
NHS Fife
NHS Forth Valley
NHS Grampian
NHS Greater Glasgow & Clyde
NHS Highland
NHS Lanarkshire
NHS Lothian
NHS Orkney
NHS Shetland
NHS Tayside
NHS Western Isles
Rest of UK
Outwith UK
Country of birth
Length of time in Scotland prior to death YY/MM
Ethnicity See code list
At the time of death, was the child:
Member of a travelling family Y/N
Unaccompanied asylum seeker Y/N
Member of asylum seeking family Y/N
Recognised as homeless Y/N
Looked after child Y/N
On child protection register Y/N
Respondent identifiers
Individual registering the death
Forename
Surname
Address
Postcode
Date of registration DD/MM/YY
Doctor certifying the death
Forename
Surname
Business address
Business contact telephone number
Consultant responsible for deceased as a patient
Registered GP
Forename
Surname
Surgery address
Each individual completing information gathering template
Forename
Surname
Job title
Place of work
Address
Postcode
Tel
Email
Date of completion DD/MM/YY
Circumstances of the death
Type of death Neonatal death
May trigger additional type specific data collection forms. Death of a child with a life limiting condition
SUDI
Road traffic accident
Drowning
Fire/burns
Poisoning
Other non-intentional injury
Substance misuse
Apparent homicide
Apparent suicide
Death expected ie death anticipated as a significant possibility in 24 hours before the death (or before the collapse that precipitated the events leading to death) Y/N
Medical certificate of cause of death issued Y/N
Registered cause of death
Ia
Ib
Ic
Id
Ie
Death referred to Procurator Fiscal? Y/N
Post mortem intended or carried out? Y/N
Post mortem carried out? Y/N
Other reviews conducted on death (concluded/ongoing)
Critical incident review Y/N
SUDI review Y/N
Significant case review Y/N
Fatal accident inquiry Y/N
Other, eg Adverse Event Review, Medical certificate of cause of death (MCCD)?
Cause of death - provisional description
Circumstances of death - provisional description
Date of death DD/MM/YYYY
Time of death 00.00-24.00
Age at death YY/MM
Place of death - address
Place of death - postcode
Place of death - type Neonatal unit
A&E
Paediatric ward
ICU/HDU
Psychiatric hospital/unit
Hospice
Family home
Other private residence
Residential care setting
School/nursery
Public place
Outwith Scotland
Other
Not known
Date of event leading to death
Time of event leading to death
Place of event leading to death - address If applicable eg onset of acute medical condition or injury that lead to the death
Place of event leading to death - postcode
Place of event leading to death - type
Child's medical history
Gestation at birth WW (completed weeks)
Birthweight In gms
Multiple birth Singleton
Twin
Triplet or more
Perinatal issues
Developmental issues/disability
Physical health issues
Mental health issues
Child on medication at time of death Free text
Alcohol or substance misuse
Summary of factors intrinsic to the child that are relevant to the death Free text
Child's educational history
Child's education/occupation status Not yet in education
Early education and childcare
School
Further/higher education
Left education - employed
Left education - unemployed
School/nursery attended Name, address, postcode
Family/carers and household
Number of adults living in child's usual place of residence
For each adult
Date of birth/age DD/MM/YY or YY
Gender M/F
Relationship to child
Health or social issues? Eg physical health, mental health, disability, alcohol or substance misuse
Number of children living in child's usual place of residence
For each child
Date of birth/age DD/MM/YY or YY
Gender M/F
Relationship to child
Health or social issues? Eg physical health, mental health, disability, alcohol or substance misuse
Other carers living elsewhere
For each carer
Date of birth/age DD/MM/YY or YY
Gender M/F
Relationship to child
Health or social issues? Eg physical health, mental health, disability, alcohol or substance misuse
Other siblings living elsewhere
For each sibling
Date of birth/age DD/MM/YY or YY
Gender M/F
Relationship to child
Health or social issues? Eg physical health, mental health, disability, alcohol or substance misuse
Was the child ever looked after or on the child protection register? Y/N
Have any siblings ever been looked after or on the child protection register? Y/N
Summary of factors in the child's family, household, and wider social environment that are relevant to the death Free text
Services involved with child
Were the following services involved with the child at the time of death (or during the final illness)? Primary health care
Secondary health care
CAMHS
Hospice
Early education and childcare
Education
Social work
Scottish Children's Reporter Administration
Other
Summary of factors relating to the services being provided to the child/family that are relevant to the death Free text
Delivery of review
Date of CDR DD/MM/YYYY
Duration H, MM
Agencies/specialties represented at review meeting Primary health care
Neonatology
Paediatrics
Child and adolescent mental health
Public health
Ambulance service
Other healthcare
Police
Fire service
Procurator Fiscal
Social work
Early education and childcare
Education
Family representative
Other
Family involvement in review Submitted written information
Review findings to be provided to family in written format
Review findings to be discussed with family
Information gathering template available from Primary health care
Secondary health care
CAMHS
Hospice
Early education and childcare/Education
Social work
Other
Outcome of review
Cause of death - final description Free text
Cause of death - classified Deliberately inflicted injury, abuse or neglect
Suicide or deliberate self-inflicted harm
Trauma and other external factors
Malignancy
Acute medical or surgical conditions
Chronic medical condition
Chromosomal, genetic and congenital anomalies
Perinatal/neonatal event
Infection
Sudden unexpected, unexplained death
Factors that may have contributed to the child's death Categorise each specific category marked 0-3 as
0 No information available
1 No factors likely to have contributed to death
2 Factors identified that may have contributed to death
3 Factors identified that provide a complete and sufficient explanation for the death
Intrinsic to child
Summary Free text - include strengths and difficulties
Perinatal issues Free text / 0-3
Acute physical illness Free text / 0-3
Chronic physical illness Free text / 0-3
Emotional / behavioural / mental health condition Free text / 0-3
Developmental problem or disability Free text / 0-3
Alcohol or substance misuse Free text / 0-3
Child's Family and social environment
Summary Free text - include strengths and difficulties
Poor parenting / supervision Free text / 0-3
Child abuse / neglect Free text / 0-3
Physical health of parent / carer Free text / 0-3
Mental health of parent / carer Free text / 0-3
Alcohol or substance misuse by parent / carer Free text / 0-3
Domestic violence in home Free text / 0-3
Family breakdown Free text / 0-3
Family finances Free text / 0-3
Child's wider/physical environment
Summary Free text - include strengths and difficulties
Home safety Free text / 0-3
Other physical environment safety issue Free text / 0-3
Bullying Free text / 0-3
Gang culture Free text / 0-3
Wider social and policy environment Free text / 0-3
Service provision/delivery
Summary Free text - include strengths and difficulties
Recognition of sick child Free text / 0-3
Team working/coordination of care and support Free text / 0-3
Access to/availability of services Free text / 0-3
Summary and actions
Case summary Free text
Issues relating to the delivery of the review Free text eg agencies not represented information not submitted to panel
Modifiable factors identified? The panel has identified one or more factors which may have contributed to the death and which, by means of locally or nationally achievable interventions, could be modified to reduce the risk of future child deaths - Y/N
Modifiable factors identified - description Free text
Learning points Free text
Recommendations Action
Relevant agency
Level (local/regional/national)
Refer death to another agency Police
Procurator fiscal
Health and Safety Executive
Serious Case Review panel
Other?
Follow up plans for the family Free text

Code list for ethnicity

Group A - White

1A - Scottish

1B - Other British

1C - Irish

1K - Gypsy/Traveller

1L - Polish

1Z - Other white ethnic group

Group B - Mixed or multiple ethnic groups

2A - Any mixed or multiple ethnic groups

Group C - Asian, Asian Scottish or Asian British

3F - Pakistani, Pakistani Scottish or Pakistani British

3G - Indian, Indian Scottish or Indian British

3H - Bangladeshi, Bangladeshi Scottish or Bangladeshi British

3J - Chinese, Chinese Scottish or Chinese British

3Z - Other Asian, Asian Scottish or Asian British

Group D - African

4D - African, African Scottish or African British

4Y - Other African

Group E - Caribbean or Black

5C - Caribbean, Caribbean Scottish or Caribbean British

5D - Black, Black Scottish or Black British

5Y - Other Caribbean or Black

Group F - Other ethnic group

6A - Arab, Arab Scottish or Arab British

6Z - Other ethnic group

Group G - Refused/Not provided by patient

98 - Refused/Not provided by patient

Group H - Not Known

List for place of event leading to death and place of death

Acute hospital Family home

Neonatal unit Foster home

A&E Other private residence

ICU/HDU Residential care setting

Psychiatric hospital/unit School/nursery

Paediatric ward Public place

Hospice

Outwith Scotland

Other

Not Known


Contact

Email: Mary Sloan