I’m David Holmes, the Chair of the Child Safeguarding Practice Review Panel.
Did you know that last year over 360 children in England were reported to have died or been seriously harmed in serious safeguarding incidents, where abuse or neglect was known or suspected.
360 children.
The local safeguarding reviews, whether they were rapid reviews or local child safeguarding practice reviews of all these very serious incidents, were all read and very carefully considered by the Panel I chair. It’s part of our role to identify and share learning nationally, and it’s a big responsibility.
The Panel has now published its latest annual report for the year 2024 to 2025, and I wanted to talk to you today about some of its key findings.
Our annual report brings together key themes and learning from local safeguarding reviews. When we take that learning alongside our national programme of work, it provides a unique, system‑wide picture of both child protection practice and leadership across England.
The report is essential reading for everyone with safeguarding responsibilities.
This year, we were concerned to see a 21% decrease in the number of serious incidents reported to the Panel. At first glance, that might seem encouraging. But we are clear that this is of concern, as it is more likely to reflect under‑reporting of serious incidents rather than fewer children being harmed.
When incidents are not reported to us, vital learning is lost and children will inevitably remain at increased risk because that learning hasn’t been shared. That is why it is so important that every serious incident is accurately reported to us and thoroughly reviewed, so learning can be shared and acted on across the entire safeguarding system.
I know that sometimes safeguarding partnerships are not sure whether a particular incident meets the threshold for reporting. In those cases, please do reach out to the Panel, talk to us, and we can help advise whether or not the incident should be reported.
The analysis in our annual report shows that the most affected age group for serious incidents — accounting for 34% of all rapid reviews considered by the Panel — were babies, children under one. This is a pattern we have seen in previous years and highlights the vulnerability of our youngest children. It underlines why we should all be vigilant about keeping babies safe.
Very sadly, the leading causes of child death in the period covered by this report were sudden, unexplained death in infancy or childhood, suicide, or intra‑familial assault. For children who suffered serious harm, neglect and intra‑familial assault were the leading causes.
Our analysis also shows that many children involved in serious safeguarding incidents are living in very complex circumstances. Children and families are often facing multiple overlapping challenges, including poverty, housing insecurity, domestic abuse, parental substance use and mental ill health. I know this will be very familiar to all of you working in safeguarding.
Keeping children safe in this context requires strong and effective multi‑agency working. It means sharing information well and in a timely way, assessing risk thoroughly and sometimes continuously, and providing coordinated, tailored support that reflects the realities of children’s and families’ lives.
Our annual report has been published at a time of significant change across children’s social care, health, policing, education and SEND services, and as we look ahead to the establishment of a new Child Protection Authority. Amidst all this change, the Panel’s focus remains crystal clear.
Lessons from serious incidents must be shared and understood by all of us, and that learning must lead to real, lasting improvements, so that children are better protected and families are better supported.
There is a huge role for the Panel in ensuring that learning is shared with you as accessibly as possible. We understand that keeping children safe is difficult and highly skilled work, and we are full of admiration for the brilliant work that you do every day.
But the fundamentals matter: accurate recording, really good risk assessment, strong multi‑agency working, effective information sharing, and timely support for children and families.
It is only by sharing what we are learning and working together across agencies that we can make meaningful and sustained improvements for children.
I encourage you to read the full annual report and explore the learning and resources available on our new website. And as ever, I thank you for everything you do to keep children safe.
Thank you very much.
