To ensure that NHS England continues to commission high quality independent investigations that influence and support system wide development and improvement, NHS England commissioned an external review of all Independent Investigations following Mental Health Homicides (IIMHH) and the national governance arrangements underpinning this work. The review considered investigations undertaken between 2013 – 2017.

NHS England have accepted the report findings and have developed an action plan which is being implemented and monitored via the regional and national governance mechanisms.

NHS England’s Independent Investigation Governance Committee would like to thank the authors, external partners, lay representatives and regional leads who contributed to the review.

• An independent review of the Independent Investigations for Mental Health Homicides in England (published and unpublished) from 2013 to the present day – Section one: Executive Summary
• An independent review of the Independent Investigations for Mental Health Homicides in England (published and unpublished) from 2013 to the present day – Section two: Main report