Publication - Advice and guidance

National Guidance for Child Protection Committees for Conducting a Significant Case Review

Published: 31 Mar 2015
Children and Families Directorate
Part of:
Communities and third sector

This guidance has been superseded by the 2021 Learning Review guidance, available at

National Guidance for Child Protection Committees for Conducting a Significant Case Review


In the context of child protection, a Significant Case Review is a multi-agency process for establishing the facts of, and learning lessons from, a situation where a child has died or been significantly harmed. Significant Case Reviews should be seen in the context of a culture of continuous improvement and should focus on learning and reflection on day-to-day practices, and the systems within which those practices operate. Wherever possible, staff should be involved in reviews and should get feedback when the review is finished. It is also important to work to clear timescales (see Figure 1).


The overarching objectives of Significant Case Reviews are to:

  • Establish whether there are lessons to be learned about how better to protect children and young people, and help ensure they get the help they need when they need it in the future;
  • Learn and improve services as well as recognise good practice;
  • If and when appropriate, make recommendations for action (albeit that immediate action to improve service or professional shortcomings need not await the outcome of a formal review);
  • Consider how any findings, recommended actions and learning will be implemented;
  • Address the requirement to be accountable, both at the level of the agency/agencies and the occupational groups involved;
  • Increase public confidence in public services, providing a level of assurance about how those services acted in relation to a significant case about a child; and
  • Identify national implications (where appropriate) including good practice.

This national guidance supports the achievement of these objectives by helping those responsible for reviews to:

  • Undertake them at a level which is necessary, reasonable and proportionate;
  • Adopt a consistent, transparent and structured approach;
  • Identify the skills, experience and knowledge that are needed for the review process and consider how these might be obtained;
  • Address the needs of the many different people and agencies who may have a legitimate interest in the process and its outcome; and
  • Take account of the evidence base.

It sets out:

  • The criteria for identifying whether a case is significant;
  • The procedure for undertaking an initial case review (ICR);
  • The process for conducting a significant case review including reporting mechanisms and dissemination of learning; and
  • Tools to support the process of conducting an ICR and an SCR.

This guidance builds on the recommendations of the short life working group of June 2010, supports the refreshed National Child Protection Guidance Scotland 2014 and is informed by research evidence.[1] It seeks to support consistency of approach nationally and improve the dissemination and application of learning both locally and nationally.

The assumption throughout this guidance is that the Child Protection Committee (CPC) should proceed as speedily as feasible at all stages of an ICR and SCR, and that agencies should do the same. This is important in reducing stress on the child (if they are still living); their family or carers; and on the staff involved. However, the complexity or circumstances of certain cases may result in preferred timescales not being met.