The objective of this study was to examine the challenges faced by child protection systems in assessment and case management where babies and infants have received serious and fatal physical injuries in the context of discrepant parent/carer explanations. Thirty-eight case files or review records of children under the age of 2 with serious or fatal physical injuries were examined. Qualitative methods were employed to identify issues relating to types of parent/carer explanations, factors of concern in addition to the injuries and child protection system responses to the families. Findings indicate that the initial safety response by child protection systems to babies with serious injuries with discrepant explanations can be inadequate. Assessment of further risks could be inconsistent, especially in cases where there are few other factors of concern apart from the injury. There is a need for the development in the UK of more systematic decision-making processes to achieve more consistent standards of assessment and case management of high-risk infants and to minimize false-negative and 'More systematic decision-making processes to achieve more consistent standards of assessment and case management' O ur combined experience in child protection practice, management, evaluation and research over more than two decades highlights that there is a particular group of cases that present significant challenges to child protection system
