Our training and resources

Learning briefing: Alex – non-accidental injury (2025)

The incident

In January 2025, Alex, a 19-month-old child, attended hospital with a fractured upper left arm. Initially attributed to a fall, further investigation revealed multiple fractures indicating non-accidental injuries. Subsequent police involvement due to domestic abuse reports led to the arrest of Alex’s mother and her partner. Alex and their siblings were placed in foster care under Interim Care Orders.

Good practice

  • Primary School: Conducted home visits and supported the mother during domestic abuse incidents.
  • Hospital: Provided admission for the family due to their social circumstances in the absence of a medical need, ensuring safety while further investigations were conducted.
  • ED Registered Nurse: Raised safeguarding concerns promptly.
  • Multi-Agency Collaboration: Effective use of escalation processes and strategy meetings to coordinate child protection medicals and safety plans.

Messages for practitioners

  • Timeliness: Ensure rapid response to safeguarding concerns in order to mitigate risks promptly, where convening a Strategy Meeting supported by detailed agency research may cause delay.
  • Trauma-Informed Practice: Recognise and understand the behaviours of individuals experiencing domestic abuse.
  • Multi-Agency Communication: Utilise hospital safeguarding teams and share information across agencies to provide comprehensive support.
  • Child’s Lived Experience: Focus on the child’s overall environment and experiences, not just isolated incidents.

What can we do next?

  • Improve Strategy Meeting Timeliness: Establish processes for urgent deployment of police and social workers for fast-track safeguarding activities.
  • Enhance Non-Accidental Injury Awareness: Train key hospital staff to recognise non-accidental injuries in children.
  • Expand Operation Encompass Notifications: Include electively home educated children in domestic abuse notifications.
  • Strengthen GP Responses: Ensure GPs take appropriate actions upon receiving Police Public Protection Notices.
  • Promote Trauma-Informed Practice: Leaders should ensure there are CPD opportunities focusing on domestic abuse within healthcare settings.
  • Refine Decision Making: Improve the quality of outcome decisions at the Front Door, ensuring comprehensive analysis and robust Early Help plans.

If you think that the child is at risk of significant harm, contact our Front Door directly by calling 0345 155 1071. In an emergency call 999.


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