The sudden and unexplained deaths of children (SUDC) represent an incomprehensible tragedy, leaving families devastated and grappling with profound grief. Inquests into such cases are inherently emotionally draining, as parents seek answers and closure amid the bewildering loss of a young life.
SUDC are, as the name suggests, defined as the sudden and unexplainable (even after an investigation) death of a child (1-17 years old). A recent BBC Panorama programme exploring SUDC identified that, in the past 30 years, awareness and investigations into deaths of infants under the age of 1, also known as ‘cot deaths’ or SIDS (Sudden Infant Death Syndrome) has increased and led to an 80% drop in the amount of such deaths. Yet, sadly, there remains less understanding of SUDC deaths affecting slightly older babies and children.
SUDC Nurses
The role of a SUDC Nurse is paramount in providing essential support and guidance to families during the most challenging of times. SUDC Nurses serve as compassionate and knowledgeable allies, offering emotional support, information, and resources to help families navigate the complex landscape of grief and uncertainty.
When a child dies unexpectedly in England and Wales, the NHS is obligated to conduct a review into what happened and allocate a key worker to guide the bereaved family through the process – this is known as a Child Death Review Procedure (CDOP). Whilst CDOPs are required by statute, how individual commissioning bodies interpret the requirements varies across England and Wales. Similarly, how SUDC teams operate, and whether they are nurse or paediatrician led, fluctuates geographically. I am currently seconded to an NHS Trust which was one of the first Trusts to launch a SUDC nurse-led programme as opposed to the traditional paediatrician-led model.
The role of the SUDC Nurse is to participate in the Joint Agency Response (JAR), which initially takes place in the immediate aftermath of the death and then again 24-48 hours later. The SUDC Nurse also supports the deceased’s family throughout the investigation process that occurs after a SUDC event, as well as playing a vital role in liaising with other agencies that may be involved such as the coroner, the police and social services.
Representation at inquest
BBC Panorama followed the story of two parents in Sheffield who sadly lost their 2 year old son. Prior to the inquest, the parents tried but were unsuccessful in securing legal representation. At the end of the inquest, they were left without answers as the postmortem identified that their child had fallen asleep and not woken up, but no medical explanation for the death could be given.
The couple said that the coroner provided medical documents which they found hard to understand. This is understandably an incredibly difficult conclusion to digest, as they were left without answers and more questions arising from their review of the unfamiliar medico-legal documents.
Legal aid
Families facing inquests face a battle to acquire legal aid funding. Current policy directs that legal aid is only granted under exceptional circumstances, such as cases involving the Human Rights Act. The non-availability of automatic legal aid for families at inquests is the subject of longstanding debate. Public bodies and other large organisations may choose to pay for legal representation at inquests, whilst families must either fund representation themselves, or meet strict circumstances to be granted legal aid. Unfortunately, the complex nature of SUDC cases, involving intricate medical and forensic issues, may not always align with the narrowly defined parameters for legal aid. As a result, families, who may be grappling with the emotional and financial aftermath of losing a child, find themselves caught in a legal system that does not recognise the unique challenges posed by SUDC cases. The inherent limitations in legal aid policies may inadvertently exclude families from the crucial support and expertise they need during the inquest process, adding an additional layer of distress to an already heartbreaking situation.
Conclusion
In the absence of automatic legal aid funding, the SUDC nurse becomes an indispensable anchor, empowering families with the tools to traverse the challenging journey of seeking answers and justice after the sudden and unexplained loss of a child. The advocacy, empathy, and unwavering support of the SUDC Nurse contribute significantly to easing the emotional burden that families bear during this profoundly difficult time.
For further information, please contact:
Harriet Morgan, Hill Dickinson
harriet.morgan@hilldickinson.com
