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PRUDiC (Procedural Response to Unexpected Deaths in Childhood)

The 2023 revision of the Procedural Response to Unexpected Death in Childhood (published in 2010, revised 2014 and 2018) sets out a minimum standard for the multi-agency response to the unexpected death of a child or young person. The aim of the PRUDiC is to ensure that this response is safe, consistent and sensitive to those concerned and that there is uniformity in the approach taken across Wales. The procedure should be implemented in all unexpected child deaths and followed to completion at the Case Review Meeting.
 
The 2023 revision was facilitated by the National Safeguarding Service (NHS Wales) on behalf of the Regional Safeguarding Boards across Wales. Following a period of engagement with key stakeholders, a multi-agency workshop was held in November 2022 to agree proposed changes to the procedure.  The draft PRUDiC 2023 was circulated comment via the Wales NHS Safeguarding Network and Regional Safeguarding Boards.  Amendments were made in response to comments and the final document was issued for implementation from April 2023. A webinar was held to detail the changes in March 2023.
 
This revision introduces a number of changes to the PRUDiC Process, which aim to strengthen partnership working around child death. This includes some changes to

  • Information Sharing
  • Disagreement on Initiation of PRUDiC process
  • New chapters on Unexpected Neonatal Deaths, Organ and Tissue Donation, Suicide, Independent Medical examiner, when a Child Dies Unexpectedly in Another Area, Unexpected Deaths on Paediatric Critical Care Unit (PCCU) 16 & 17 Year Olds Who are Cared for in Adult Areas of the Health Board  
  • Emotional Safety and support for Staff Attending PRUDiC meetings

It is hoped that the publication of the new Procedural Response will further enable consistent, supportive and effective investigation of Unexpected Child Deaths within Wales.

Guidance:

Beat Flu   Procedural Response to Unexpected Death in Childhood

Appendices:

Beat Flu   Appendix 3 - Proforma for History and Physical Examination of the Child 

Beat Flu   Appendix 4 - Scene Examination Checklist for Infants and Children Under 24 Months   

Beat Flu   Appendix 5 - Child Death Notification Form

Beat Flu   Appendix 6 - Case Summary Template 

 

Self Harm & Suicide

Self harm results in significant yearly admissions in Wales across all ages and is one of the top five causes of medical admissions. Self harm is the strongest risk factor for suicide, the second leading cause of death in the 15 to 19 year old population. However, only a very small fraction of those who self harm go on to make suicide attempts or die by suicide. The risk factors for young people who self harm are consistent with other safeguarding risks such as child abuse and neglect, substance misuse, intimate partner violence and sexual exploitation.
 
Front line health professionals play a key role in the management of those who self harm. Often they are the first contact for the young person with support services and this has a significant impact on the outcome for the young person and future help seeking. Young people who have self harmed need to be cared for with compassion and the same respect and dignity as any service user.

Suicide and self harm prevention strategy 2015 to 2020 identifies the priorities for organisations in Wales.

Guidance:

Beat Flu   Suicide and self harm prevention strategy 2015 to 2020