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

Telford and Wrekin review

CSP: Telford and Wrekin Published: June 2026 Year of death: 2023 Extracted: 16 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
This review highlights the increased risk of suicide among domestic abuse perpetrators and identifies systemic issues in agency responses to domestic abuse allegations, including counter-allegations and inconsistent risk assessment. It also notes gaps in routine domestic abuse enquiry in primary care and systematic bereavement support.

Home Office classifications

27 tags

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

  • Victim - died by suicide
  • Victim - alcohol misuse
  • Victim - substance misuse
  • Victim - mental ill health
  • Victim - anxiety
  • Victim - depression
  • Victim - self harm
  • Perpetrator - alcohol misuse
  • Perpetrator - mental ill health
  • Perpetrator - anxiety
  • Perpetrator - known to agencies as a domestic abuse perpetrator
  • Perpetrator - known to police as a domestic abuse perpetrator
  • 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 supported by expert specialist advocate
  • DHR process - police recommendations
  • DHR process - health services recommendations
  • DHR process - community safety partnership recommendations
  • DHR process - identification of risk recommendation themes
  • DHR process - policy recommendation themes
  • DHR process - awareness raising recommendation themes
  • DHR process - other recommendation themes

Extracted recommendations

16 recommendations pulled from the report · 9 matched to organisations in the index

Recommendation 1

Addressed to Home Office

The Home Office to consider liaising with the Department of Health and Social Care and NICE to ensure that there is consistency across all clinical guidance for routine enquiry into domestic abuse for relevant health conditions which are evidence-based indicators of potential domestic abuse, such as those for depression and anxiety specifically.

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

Recommendation 2

Addressed to Telford and Wrekin Public Health Team | ICB

Telford and Wrekin Public Health Team with the ICB, through the Primary Care Networks (PCNs) and GP Safeguarding Leads, to provide assurance to the Domestic Abuse Local Partnership Board that the domestic abuse pathway for primary care, which includes the PCN social prescribers, is effective in identifying and responding to domestic abuse in primary care.

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

Recommendation 3

Addressed to Telford and Wrekin Suicide Prevention Action Group

Telford and Wrekin Suicide Prevention Action Group, coordinated by the Public Health Team, to ensure that domestic abuse perpetrators, as well as domestic abuse victims, feature within their suicide prevention strategy.

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

Recommendation 4

Addressed to Telford and Wrekin Public Health

Telford and Wrekin Public Health to liaise with the Coroner and encourage local sign-up with the Real Time Suspected Surveillance System

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

Recommendation 5

Addressed to Home Office

Home Office to liaise with the chief coroner in respect of guidance to coroners to ensure that all coroners are part of Real Time Suspected Surveillance System

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

Recommendation 6

Addressed to West Mercia Police | Telford Mind

West Mercia Police and Telford Mind to work together to strengthen links and develop a referral route which will ensure that bereaved families are systematically offered signposting to specialist support services following police attendance at a sudden death.

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

Recommendation 7

Addressed to Home Office

The Home Office to consider adding to their suite of leaflets for families and friends, leaflets specifically concerning domestic abuse related suicides.

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

Recommendation 8

Addressed to Safer Telford and Wrekin

Safer Telford and Wrekin to ensure that a suicide prevention specialist sits on all future Domestic Abuse Related Death Reviews involving suicide in their area

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

Recommendation 9

Addressed to The GP Practice

Clinicians to ask about abuse when patients present with depression, anxiety or low mood

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

Recommendation 10

Addressed to The GP Practice

Clearly Identify the reason for a patient seeking medical attention and highlight this to the consulting clinician in case of lack of contact with the patient

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

Recommendation 12

Addressed to Lancashire Constabulary

Separate investigators are allocated to cases where both alleged offender and alleged victim make allegations of domestic abuse against each other.

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

Recommendation 13

Addressed to Lancashire Constabulary

Provide evidence of improved quality of domestic abuse investigations (completed).

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

Recommendation 14

Addressed to West Mercia Police

Provide evidence-based assurance that reports of harassment are robustly investigated, including those received by email, and victims updated of progress in line with the Victim’s Code

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

Recommendation 15

Addressed to West Mercia Police

Provide evidence-based assurance that cases of stalking and harassment are adequately supervised and not closed prematurely

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

Recommendation 16

Addressed to West Mercia Police

Provide evidence-based assurance on the robustness of referral pathways to support services

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