education- 2018

Lost School Child in Major Transport Hub - Case Study

This case study relates to a real incident where a primary school aged child became separated from the group and school staff whilst in a major transport hub. Some of the specifics of the incident have been diluted/omitted in order to anonymise the case study. The very important lessons to be learnt are below and these apply to anyone supervising, or planning the supervision of, children or vulnerable persons.

These lessons are split into preventative and reactive actions:


  • A suitable and sufficient risk assessment that considers all reasonably foreseeable aspects of the visit should be conducted. Relevant information from the risk assessment should be shared with the staff team in good time before the activity, allowing time for queries and revisions. Age appropriate information should also be shared with the participants in advance.
  • Participants additional needs (e.g. SEND) are considered in the planning stages in order that the activities are inclusive and risks are managed. Where appropriate, individual risk assessments are conducted and specialist staff involved.
  • Supervision is planned in a way that is appropriate for the group and individuals within the group. Staff are competent in their role (including volunteers) and an effective level of supervision (ratio) is in place.
  • Where there is a broad age range or abilities of participants involved, the differences in supervision levels are recognised and reflected in the planning and actions taken.
  • Where handover of supervision from one staff member to another takes place, there is confirmed agreement/acceptance of this and young people are made aware of who is now supervising them.
  • Potential failure points in supervision are identified (e.g. intersections, forks in route, blind corners, entry/exits, crossings, busy areas, lifts, revolving doors, embarking/disembarking vehicles etc.) and planned for. Preventative control measures are in place (head counts, rollcall, registers, buddy system, rear observer for group etc.) The group is then appropriately supervised in practice.
  • You could consider making participants more visible for staff (school uniform, coloured hats etc.)
  • Emergencies/Incidents are planned for. Staff know the details of the plan and have practiced it. Staff have supporting prompts (e.g. action cards) with them and access to Senior Leadership to support them in an emergency.
  • Participants know what to do if they become separated from the group (for example remain at the venue/seek uniformed support etc.).


  • Swiftly establish who is lost (head count, register), a last seen point and a description (appearance, build, clothing etc.)
  • Split into two teams: one to supervise the group and one to begin searching.
    Team one should ensure the group are in a place of safety and reassure them, attend to their needs. Team two should follow the lost child plan and conduct a quick search of likely immediate area and ask the venue for support if relevant.
  • If a quick search is not successful, activate your emergency plan and refer to action cards etc. Allocate roles to complete tasks rapidly and effectively.
  • Call the police. Do not delay doing this (this was fully encouraged by both Forces involved in the case study incident). Follow their advice and direction.
  • Liaise with the venue you are at so they can use CCTV, deploy security etc.
  • Notify the base emergency contact so that they can involve wider support from the employer.
  • Refer media to the employer. Do not speak to the media ‘on the ground’.
  • Keep a log of actions taken, when, by who etc.

Thankfully the child in the case study was found, after many hours, and had not come to any harm. There, however, could have been a much worst outcome save for a lot of good luck.

Further detailed and specific advice regarding educational visits planning can be accessed via your Outdoor Education/Educational Visits Adviser. National Guidance (NG) from the Outdoor Education Advisers Panel (OEAP) can be accessed at https://oeapng.info. The section specifically relating to emergencies is Emergencies and Critical Incidents | (oeapng.info). This includes model plans, action cards and other guidance.


Disclaimer: The information and opinions expressed on this webpage are those of the author and not necessarily those of the Institution of Occupational Safety and Health (IOSH).