How is the Rapid Response Investigation of unexpected infant and child deaths working

How is the Rapid Response Investigation of unexpected infant and child deaths working?  A national investigation of parent perceptions and information provided to coroners.
Professor Peter Fleming, Peter Fleming, Pete Blair, & Anna Pease. School of Population Health Sciences, Bristol Medical School, University of Bristol, (Funded by the Lullaby Trust. REC approval reference: 14/SW/1084)

The Rapid Response investigation of unexpected deaths of infants (SUDI) and children (SUDC) was implemented by CDOPs from 2008.

We report a national study of SUDI and SUDC from birth to 4 years in 2010 – 2017, including telephone interviews with bereaved parents and detailed information from coroners.

From 97 initial contacts, we obtained complete data (including coroner information) for 91 families (65 SUDI and 26 SUDC).

Family experiences of the Rapid Response system varied: 76% had contact with a paediatrician, 67% within a day. 89% had contact with a police officer, 86% within a day.  Home visits were conducted for 78%, but only 18% reported a joint visit by police and a health professional.

89 post-mortems were done by paediatric pathologists, many with a forensic pathologist, 2 by forensic pathologists alone. Follow-up appointments to explain findings were reported by 47% of families.

Families reported feeling unable to ask questions at inquest, “under suspicion” by professionals and some were sent copies of the post-mortem in the post. Families particularly valued home visits, and wanted personalised information rather than generic bereavement support.

While investigations have improved, attention should be paid to engaging health professionals in the care and support of bereaved families.

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