When six-year-old Arthur Labinjo-Hughes and 16-month-old Star Hobson’s deaths from appalling physical abuse became widely known in December there was an outpouring of public anger, grief and questions about how this could possibly have been allowed to happen. The review into their deaths, published yesterday provides some answers – but fails to engage fully with some vitally important issues. First, the review rightly emphasises that both children had the misfortune to be in the care of exceptionally cruel parents and step-parents. Social workers never saw Arthur on his own to hear from him what his life was like, and they didn’t get close to Star either, focusing predominantly on her parents. But a vital message from the review is that the concerns of children’s wider families must be taken very seriously. Star and Arthur’s other relatives could see their deterioration and made reports, including sending photos and videos of bruising to the children that were, after investigation, regarded by professionals as malicious. Above all, the review argues that the key reason the children were not protected was poor communication and collaboration between professionals. Strategy meetings to pool their knowledge didn’t happen. Yet it also confronts the reality of the very difficult organisational conditions social workers had to work in, with staff vacancies, high caseloads and low morale. The children’s social care service in Bradford that worked with Star was “in turmoil”. The social worker who carried out a crucial home visit to see Star was a temporary agency worker who left Bradford before the assessment was complete, and the inquiries into the child’s safety were allowed to fizzle out. The review wants to bring about a step-change in structures and processes in England that will improve communication and decision-making between professionals, recommending the establishment of multi-agency child protection units made up of experienced, skilled social workers, police, psychologists, doctors and heath staff. The review wants the units to put all of the evidence together, interrogate it, challenge each other’s perspectives, and agree a coordinated and strong response. However, while huge attention is given to the need to create such new systems, the psychological and emotional impact of doing child protection work does not get enough attention. A consistent finding in more than 40 years’ worth of child death inquiry reports is that what appeared to be straightforward tasks, such as sending a photograph to another professional, simply didn’t get done. This requires us to explain the unexplainable – and why, time and time again, well-intentioned professionals can’t explain even to themselves their inaction in the face of evidence of marks and injuries. To fully understand what happens when professionals are in the presence of abused children, careful attention must be given to the impact that the stress and anxiety that pervades the work has on professionals’ capacities to think, or not think clearly. My 12 years of research, based on observing face-to-face encounters between social workers and families, shows that those who fill professionals with the most dread and anxiety are parents hostile to involvement. Faced with threats, intimidation or passive aggression in parents not answering the door, the intense anxiety professionals experience clouds their judgement and makes it extremely difficult to think about and tune in to the children, or to even recognise that they have failed to do so. Moreover, the crucial work with Arthur and Star went on during the first phase of the Covid-19 pandemic and lockdowns, a time when, our research shows, social workers’ anxieties rose hugely owing to fears of catching and spreading coronavirus and having to try to interact with and observe children while social distancing. The review concludes that Covid-19 “had some impact on the effectiveness of the response to concerns about bruising to Arthur and subsequent decision-making”, but we need to take the next step of accepting the unavoidable limits to child protection at that unique time, and fully understanding the impact of unbearable levels of complexity and anxiety on social workers. Managing public expectations about what is possible and not possible to achieve in child protection is absolutely vital. In Solihull, the level of abuse and threats towards social workers in the aftermath of Arthur’s death has meant some having to leave their own homes according to one council leader. This inhumane public response, fed by hostile media coverage, only makes social workers jobs and keeping children safe even harder. There are vital lessons to be learned from this Review about the missed opportunities to protect Arthur Labinjo-Hughes and Star Hobson. While creating multi-agency child protection units may well help to make children safer, it has to be understood that there can never be certainty here, and there will be more tragic deaths. This is because day-to-day practice and information-sharing and decision-making are not just rational processes. In an area as anxiety-provoking and uncertain, and with such high stakes, as child protection the work will always involve unpredictable behaviours and unconscious, irrational thinking and non-thinking that result in errors. The key way to manage these practical realities and emotional complexities is to provide social workers and others with the kinds of well-resourced workplaces, manageable caseloads, training and quality support they need. The more compassion social workers are shown, the more money the government invests and time practitioners are given to think and understand how they are relating to children, the less likely it will be that these tragic deaths will occur in future. Harry Ferguson is professor of social work at the University of Birmingham and the author of Child Protection Practice.