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The SUDI Scotland toolkit provides information to the professions who may be involved. Many organisations play a role in investigating SUDI. As SUDI occurs rarely, some professionals may be involved in only one case. This toolkit offers a support resource for an unfamiliar occurrence, guiding professionals as to their role in the process and thereby including support for bereaved families.

Resources

Professionals may download, print or email resources to collect the information required from individual guidance or look at an overview of the process timeline showing how the various professions interact. This toolkit may also be used to produce hard copies of this resource making information easily accessible in a variety of settings. Please note that if using hard copies, the information will be updated regularly and care should be taken to ensure that the SUDI guidance being followed is up to date. The principles in the SUDI toolkit guidance may be applied to sudden unexpected deaths in children. This toolkit is not appropriate for every SUDI.

The following sections will inform other professionals involved in a SUDI of the part that police have in the investigation. Police officers will follow formal protocols in carrying out their investigation, though there may be some local variation between police forces.

Interactive timelines and flow chart
Main principles governing the investigation
At the scene
Initial observations at address where infant was discovered
Hospital procedures
Notifications and other considerations
Death reports
Post-mortem examination
Police withdrawal
Staff Support
Steps and timelines around the investigation of a SUDI
The SUDI Review
Resources & External web links

The police investigate every SUDI as instructed by the Procurator Fiscal. Rarely, there may be concern that the death is not of a natural cause. The role of the police is to identify such occasions and to assist other key professionals in establishing the cause of death.

The police have very specific tasks in recording statements from the infant’s family and other professionals involved, and also in gathering any items which, when tested, may help to identify a cause of death. Where a child in Scotland is taken to a hospital in England and life is pronounced extinct there, the matter is governed by English law and the host English police force will lead the inquiry.

 

Interactive timelines and flow chart

The interactive process timeline demonstrates the role and responsibility of the Police in relation to other professionals involved in a SUDI investigation. The scenario illustrated in the flow chart highlights some of the key points but does not aim to show everything that may arise in what is a unique circumstance for each case of SUDI.

View example scenario (flow chart) »

 

Main principles governing the investigation

As outlined in the Association Chief Police Officers Scotland (ACPOS) Investigators Guide to Sudden Unexpected Death in Infancy (SUDI), the main principles governing a police officer’s investigations are:

1. Act with sensitivity and an open mind

2. Provide an appropriate and proportionate response, ensuring preservation and recovery of evidence (taking due cognisance of the sensitivity of dealing with parents and carers), and

3. Encourage collaborative working and the appropriate sharing of information among organisations.

 

At the scene

Police officers may be called to attend a home where an infant has been found apparently lifeless. The call may come directly from the family concerned, but it is more usual for the police to be informed of a potential SUDI via the control room of the Scottish Ambulance Service. If police officers are first in attendance, their duty is to preserve life, provide first aid and medical assistance if necessary. Resuscitation following the UK Resuscitation Council basic paediatric guidelines should be followed until the ambulance service arrives, if there is any chance that the infant could be resuscitated.

If it is quite clear that the infant is dead and cannot be resuscitated it is best to inform the parents sympathetically.

In all cases a supervisory officer and detective will be summoned to the address where the infant has been discovered.

Police officers should accommodate parent wishes where appropriate, including holding their infant; this should be done in the presence of police/health staff – however, where there are suspicious circumstances the supervisory officer or detective should be consulted to make this decision. Officers should explain that any items that are taken for examination such as bedding, soft toys or prepared feeding bottles can only be returned to the parents/carers on instruction from the Procurator Fiscal.

Officers attending the address where a SUDI has occurred will have to undertake the following actions:

1. Assess circumstances

2. Explain to family the obligations and role of the police and Procurator Fiscal in every SUDI

3. Ensure that the area is not compromised from the point of view of gathering evidence, and

4. In some instances in remote and rural areas, where the infant is still in situ and apparently dead, the GP or Police Casualty Surgeon may be called to attend and confirm life extinct.

 

Initial observations at address where infant was discovered

There are some initial observations that officers will be expected to make at the location where the infant was discovered (this list is not exhaustive).

1. Record factors about the infant, including the presence of any blood, other body fluids (vomit, for example).

2. Note factors about the home environment.

3. Circumstances resulting in their attendance at the scene.

4. Information given by the parents informally at the scene.

 

Hospital procedures

1. In the majority of cases it will be the Scottish Ambulance Service who will transfer the infant to an Emergency Department. Police must therefore encourage collaborative working with health staff to find out the circumstances of the infant’s death in a sensitive manner.

2. Officers should obtain a full medical history from health staff.

3. If the police officers’ first encounter with the parents is at the hospital, they should be accompanied in the first instance by health staff and they should clarify their role in investigating SUDIs.

4. At earliest appropriate opportunity, the police should speak with the parents to record the circumstances leading to death. They will complete documentation and ensure that all information is gathered to complete a Sudden Death report for the Procurator Fiscal. The police documentation can be accessed by police on the intranet.

5. Accommodate parent wishes where appropriate, including holding their infant; this should be done in presence of police/health staff – however, where there are suspicious circumstances the Senior Investigating Officer (SIO) should be consulted to make this decision.

6. Police will note statements from health staff to include any account given to them by parents/carers.

7. Police should ensure medical samples are secured and marked by medical staff as ‘not for destruction’ – these will later become the property of the Procurator Fiscal after authorisation is given for the police to remove them.

 

Notifications and other considerations

Social work should be contacted to check if there has been any previous involvement with family.

Deploy Crime Scene Manager to examine and assess the integrity of the scene in the event that there may be criminality or to inform any future Significant Case Review.

A Detective Inspector will be appointed as the SIO and they will consider the deployment of suitably trained staff to liaise with the family and, where there are children within the family, will consider conducting Joint Investigative Interviews with social work colleagues.

The role of the Public Protection Unit will be decided by the SIO, but in any case officers from that unit will be deployed to the inquiry.

 

Death reports

The police will submit a full report of the known circumstances of the death to the Procurator Fiscal on the next available day. Further investigation required can be discussed and reported to the Procurator Fiscal as the inquiry develops.

 

Post-mortem examination

This examination will be arranged by the Procurator Fiscal and the police will be notified to attend.

The investigating officer must discuss the issue of any medical samples taken for further investigation with the Procurator Fiscal and paediatric pathologist, and ensure that the parents/carers are informed of the expected date of release of the remains.

At the direction of the Procurator Fiscal the police will provide a copy of the Sudden Death report to the attending paediatric pathologist together with any available medical records and photographs/video of the scene.

 

Police withdrawal

When the investigation closes the police will withdraw and give careful consideration to referring the family to relevant support agencies, the family GP and/or social services, where necessary.

 

Staff support

The professionals involved may require support. Some professionals may have prolonged involvement in the investigative process and will have no experience of SUDI. This toolkit provides information on staff support.

 

Steps and timelines around the investigation of a SUDI

Each case has unique circumstances which require investigation so there is never an absolute timescale to follow. However there are some milestones which should prompt professionals involved, especially when there may be information to share with the parents.

1. The police will provide the Procurator Fiscal with a Sudden Death report the next lawful day (Monday if the death occurs over the weekend).

2. Original medical records will be requested by the police on behalf of the Procurator Fiscal. These will be passed to the pathologist prior to the post-mortem examination along with digital photographs or videos of the location where the infant was found.

3. A post-mortem examination will take place as soon as possible and normally within 48 hours.

4. The paediatrician following up the case will offer to meet with the parents after 1-2 weeks to discuss the process to date and offer ensure appropriate support is available for the family

5. The final post-mortem examination report can take several months as further examinations of samples will need to be concluded.

6. The Procurator Fiscal will confirm with Healthcare Improvement Scotland that it is appropriate for the SUDI Review meeting to take place once the post-mortem examination report is available, assuming there is no suspicion of criminality. Healthcare Improvement Scotland will liaise with SUDI paediatrician for the NHS Board.

 

The SUDI Review

The SUDI Review is a multidisciplinary meeting at which the case is discussed. The meeting is held shortly after the final post mortem examination report is available, which may be several months after the infant has died. The purpose is to discuss all aspects of the death, including possible causes or contributing factors, to see what lessons can be learned and to plan support for the family, in particular during and after any future pregnancies.

Participants may include:

• paediatrician
• pathologist
• general practitioner
• community health visitor
• community midwife
• social worker.

The meeting will be held at a suitably convenient time and place for all involved. The SUDI Review meeting will not take place if there is any suspicion of criminality or if a Significant Case Review has to take place through Child Protection.