Mental Health Homicide & Serious Incident Investigations & Reviews

Mental Health Homicide & Serious Incident Investigations & Reviews

In 2013 NHS England assumed overarching responsibility for the commissioning of independent investigations into mental health homicides and serious incidents and introduced its revised Serious Incident Framework in April 2015.

Thankfully, serious incidents requiring investigation in healthcare are rare, but when they do occur systematic measures need to be in place to respond to them. Measures that protect patients, their families and carers and ensure that robust investigations are carried out, which result in organisations learning from serious incidents to minimise the risk of the incident happening again.

What Is An Independent Investigation?

All providers of NHS funded services are required to be open and transparent with families and patients when things go wrong with their healthcare. An independent investigation is carried out by an independent, expert organisation who is given access to all the information and records about the patient’s care and treatment, to carry out a thorough review and report on its findings and recommendations.

Why Sancus?

Sancus is the largest dedicated intelligence and investigations training company in the UK. We are also leading experts in undertaking serious and complex investigations for NHS England at times of crisis, with a proven track record.

Our framework for undertaking independent investigations is fully compliant with NHS England’s Serious Incident Framework guidance on undertaking an independent investigation following a homicide in mental health services.

Each investigation is conducted by a ‘Sancus Approved’ multi-disciplinary team of associates, who are leading specialists in their field. Alongside clinical and managerial expertise, many of our associates have a background in the police, which sets us apart from other investigation training companies who work within the NHS Framework.

We are also experienced in undertaking investigations with multi-agency involvement, including statutory, independent and third sectors, which has proven to increase understanding, trust and effectiveness between agencies.

All our work is carried out with integrity, professional competence and pragmatism.

How We Work

There are five main stages to Sancus investigations. Each investigation follows a defined process;

  • Initiation
  • Fact finding
  • Analysis,
  • Report writing and
  • Post investigative support

We track the progress of each investigation through a number of stages, ensuring that timeliness and quality indicators are adhered to and NHS England’s Terms of Reference are met.

Investigation Methodologies

Investigators will apply specific investigation methodologies to assist in planning, interviewing and report writing. These include Root Cause Analysis (RCA) and Professionalising Investigation Programme (PIP) 2: Serious and complex crime.

Investigators will employ critical data analysis and evidence-based, intelligence gathering to identify areas of improvement, good practice, contributory factors and lessons learnt to improve the quality and safety of services. All recommendations are measurable, achievable and sustainable to the scope of the investigation.

Quality Assurance

Sancus are committed to ensuring that all aspects of our work are completed to the highest quality standard and in strict compliance with legislation and regulations.

All associates engaged by Sancus are professionally aware of and fully compliant with the General Data Protection Regulation and Caldicott Principles; it is a condition of engagement that all personal identifiable information is processed in a safe and secure manner with access strictly restricted to colleagues who have a need to know.


Professional Award in Complaints Handling & Investigations (Level 5) – Sancus hold a professional award in Complaints Handling & Investigations at Level 5; ensuring that an investigation, the reporting of findings and recommendation are carried out to best practice standards.


Should you wish to discuss how Sancus can support you with an independent investigative review please contact Tony Hester on 01772 282800 or via email on