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An independent review into the death of 10-year-old Sara Sharif has identified multiple failings from agencies in the lead up to her murder in 2023, finding that "the system failed to keep her safe”.

The review, published yesterday (13 November), noted that when Sara Sharif's case was first in the family court in the early months of her life, social workers from Surrey County Council wanted her to be removed from her parents for her safety. However, after the initial court hearings, the plan changed.

According to the report, social workers felt that in court, "the views of the children's guardian took precedence".

The children's guardian is an expert appointed by the court to "represent the best interests of a child".

Making a recommendation in this area, the review stated: “When the independent advice of the children’s guardian and the assessment of the local authority differ, this should be recorded in line with guidance (July 2025) to enable the lead judge in the case to read in summary form, the points of difference before the judge in respect of the care plan.


“This will save the court time and will enable parties to consider these points in detail as decisions are made.”

Meanwhile, the report found “vital information” missing in the custody case, and cited racism concerns.


Responding to the report, Children’s Commissioner Dame Rachel de Souza said: “It is a catalogue of missed opportunities, poor communication and ill-informed assumptions, confirming what we always suspected: that the information needed to save Sara was available to the professionals tasked with her protection, but every part of the system lacked the curiosity to piece it together or ask tough questions, relying on the easy lies of her father and stepmother, at whose hands she died.

“[…] We already know what needs to happen: our fragmented children’s services need desperate reform, focused on prioritising resource, transformed information sharing and proper, professional accountability. But recommendations are nothing without action and implementation.”

The Children’s Commissioner has made a series of demands in response to Sara Sharif’s death:

  • Reiterating her call for a unique identifying number for every child to prevent them becoming invisible, and to make sure all the information about a child is accessible in one place;
  • A register of children not in school and stricter rules around home education to prevent any child ever known to local authorities as being at risk of neglect or abuse from being removed from school;
  • Setting national thresholds that trigger assessments to social care, removing the inconsistent practices that exist around the country, because a child’s safety must never be at the mercy of staff capacity or absence; and
  • Removal of the legal defence of ‘reasonable chastisement’ in assault law to finally grant children equal protection from assault, so that no parent can ever believe, as Sara’s father claimed, that their abuse is justified.

Terence Herbert, Chief Executive of Surrey County Council said: “Sara’s death is absolutely devastating, and we share our sincere condolences with all those affected. The criminal proceedings resulted in some justice for Sara, and the people that are responsible for her murder are rightly facing long prison sentences.

“The independent safeguarding review took place to consider the practice of all agencies throughout Sara’s life. We welcome both the national and local recommendations in the report and we take the findings with utmost seriousness.   

“We are deeply sorry for the findings in the report related to us as a local authority. We have already taken robust action to address those relating to Surrey County Council, and that work will continue with every recommendation implemented in full. We will also work with partners across the Surrey Safeguarding Children Partnership to ensure a joint action plan is implemented as quickly as possible.”

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