Home / Sources / Domestic Homicide Reviews / North East Lincolnshire · Feb 2024
About this page. This page summarises a Domestic Homicide Review published in the Home Office DHR Library. The full report is available at the source link below. Victim and perpetrator names are not included in extracted summaries on this page.
Source · Domestic Homicide Review

North East Lincolnshire review

CSP: North East Lincolnshire Published: February 2024 Year of death: 2021 Extracted: 13 recs

Statutory domestic homicide review under section 9 of the Domestic Violence, Crime and Victims Act 2004. Source: Home Office DHR Library.

Original review (PDF) ↗ Source: Home Office DHR Library

Summary AI-generated

Verify against the full report at the source link
The DHR highlights fragmented agency responses to escalating domestic abuse, including insufficient risk assessment, poor information sharing between community services and prison, and barriers to victim disclosure. It also notes the perpetrator's complex vulnerabilities and the impact of coercive control.

Home Office classifications

46 tags

Source-supplied classifications used by the Home Office to catalogue this review.

  • Victim - died by suicide
  • Victim - housing issues
  • Victim - mental ill health
  • Victim - anxiety
  • Victim - depression
  • Victim - post traumatic stress disorder (ptsd)
  • Victim - had been a victim of an abuser before
  • Victim - referred to marac at any time
  • Victim - case heard at marac before homicide
  • Children - under 18 shared parental responsibility (between victims)
  • Children - subject to child protection or domestic abuse prior to homicide
  • Children - removed into care
  • Perpetrator - alcohol misuse
  • Perpetrator - substance misuse
  • Perpetrator - housing issues
  • Perpetrator - self harm
  • Perpetrator - suicidal thoughts
  • Perpetrator - suicide attempts
  • Perpetrator - known to agencies as a domestic abuse perpetrator
  • Perpetrator - known to police as a domestic abuse perpetrator
  • Perpetrator - known to social services as a domestic abuse perpetrator
  • Perpetrator - known to idva or other domestic abuse support service as a domestic abuse perpetrator
  • Perpetrator - known to probation services as a domestic abuse perpetrator
  • Perpetrator - attended drug and alcohol services
  • Perpetrator - supervised by probation services
  • Perpetrator - died by suicide
  • Aggravating factors - separation
  • Aggravating factors - coercive or controlling behaviour
  • Aggravating factors - stalking
  • Aggravating factors - digital stalking
  • Aggravating factors - psychological or emotional abuse
  • Aggravating factors - physical abuse
  • Aggravating factors - economic abuse
  • DHR process - family contributed to dhr
  • DHR process - family consulted about terms of reference
  • DHR process - family supported by expert specialist advocate
  • DHR process - family received draft report
  • DHR process - police recommendations
  • DHR process - health services recommendations
  • DHR process - technology systems recommendation themes
  • DHR process - identification of risk recommendation themes
  • DHR process - training recommendation themes
  • DHR process - policy recommendation themes
  • DHR process - multi agency working recommendation themes
  • DHR process - record keeping recommendation themes
  • DHR process - other recommendation themes

Extracted recommendations

13 recommendations pulled from the report · 4 matched to organisations in the index

Recommendation 1

Addressed to Domestic Abuse Strategy Delivery Group

The Domestic Abuse Strategy Delivery Group should explore national best practices regarding the provision that could be put in place to focus on repeat victims of domestic abuse along with perpetrator interventions and breaking the cycle and put forward recommendations as relevant.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 1

Addressed to Government

Consider whether further guidance is required on multi-agency risk management when remanding to prison following a domestic abuse offence

Verified wording from the published review · Original review (PDF) ↗

Recommendation 1

Addressed to North East Lincolnshire Health and Care Partnership

Ensure each GP practice has a mechanism by which vulnerable patients and/ or safeguarding issues are discussed in-house, inviting multi-disciplinary colleagues as necessary.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 1

Addressed to Humberside Police

Ensure the Prison service has the contact details of the victim so they can put measures in place to prevent contact by both parties.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 1

Addressed to The Blue Door

Appropriate completion of DASH RIC, utilising professional curiosity to ensure sufficient information is captured.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 1

Addressed to We Are With You

Provide feedback to the staff team regarding the impact and importance of ensuring the service recognises and responds appropriately to changing circumstances that may affect risk.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 2

Addressed to North East Lincolnshire Health and Care Partnership

The North East Lincolnshire Health and Care Partnership should work with GPs on using flags and codes on patient records of high-risk markers of domestic abuse and self-harm and that patient summaries include this information.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 2

Addressed to Home Office

The Home Office consider whether further national policy and practice guidance is indicated on prison reception processes in checking probation and community health systems.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 2

Addressed to North East Lincolnshire Health and Care Partnership

Each GP practice should have appropriate arrangements in place to ensure robust follow-up arrangements where patients do not attend appointments. This should include a relevant “did not attend/was not brought” policy and consideration of wider vulnerability factors which inform any risk assessment and escalation processes.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 3

Addressed to The prison

The prison should review and ensure that domestic abuse training is provided to staff working in prisons and ensure that staff completing reception and health screening processes with prisoners have enhanced levels of training and awareness about checking for evidence of domestic abuse whether or not it is associated with offences relating to the prisoner arriving at the prison.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 3

Addressed to North East Lincolnshire Health and Care Partnership

Where adults at risk are under services to have recorded contact details of professionals involved in the patient's care; such as the details of an IDVA or social worker. This can be recorded in the safeguarding template on the computer system so is hidden from online access.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 4

Addressed to The prison

The prison should provide a summary of learning for the reception and health care team and review operational guidance on checking for risk flags on community-based data systems.

Verified wording from the published review · Original review (PDF) ↗

Recommendation 5

Addressed to Humberside Police | National Probation Service

The police and probation services should ensure that information about a prisoner having a history of domestic abuse is included and forwarded with the prisoner to the prison.

Verified wording from the published review · Original review (PDF) ↗