Two children suffered such neglect at the hands of their parents that one had to be airlifted to hospital with burns to a quarter of her body and another was so malnourished they struggled to use their legs.

In both cases, the Great Yarmouth children were known to a string of agencies and questions have been asked as to how the neglect was allowed to take place.

The children, known as AG and AI, were subject to serious case reviews carried out by the Norfolk Safeguarding Children Partnership.

AI, a girl of five-and-a-half, had to be taken to hospital with significant burns while in the care of her mother.

And AG, a boy who was two-and-a-half, was severely malnourished to such an extent that he struggled to walk due to vitamin deficiencies.

Both children have now been taken into care, but concerns have been raised about the way various agencies, including medical experts, social workers and health visitors handled their work with the families.

In the case of AG, the serious case review concluded: “It is difficult to understand how a child who was receiving services from a number of agencies in Norfolk was diagnosed with severe malnourishment in 2018.”

Even though the family, who came from a Traveller background, were known to health visitors, social workers and medical experts including paediatricians, the review said there was “little evidence of consideration of his faltering growth”.

The review praised the “tenacity” of a midwife, who did raise concerns and accused the social worker of “colluding” with the family.

The midwife had challenged the social worker and Norfolk County Council’s children’s services over the safety plan they had put in place around the family, who were living in a caravan containing eight people, including a new-born baby.

The review praised a physiotherapist and a safeguarding nurse for identifying the need for the little boy to have a child protection medical, which led to him being admitted to hospital with malnourishment, vitamin deficiencies, faltering growth and fractures to his arm.

The child and his brothers and sisters were taken into care and criminal proceedings are ongoing. The review has made a number of recommendations, including for health agencies to review how effectively they manage faltering growth, for all organisations to improve the way they identify and handle neglect and for training so staff can better work with people from Gypsy, Traveller and Romany backgrounds.

In the case of AI, she was admitted to hospital in August 2019, with burns to 26pc of her body, which she had suffered while in her mother’s care.

That incident came two days after children’s services had recommended their intervention with the family be stepped down from management under the Children Act to Early Help.

The girl was taken to A&E, but airlifted to a burns centre for surgery. After discharge she and her sibling were placed in foster care.

The review reported ambulances had twice been called to the home before, including for burns to the child’s hand in January 2018, triggering safeguarding referrals to children’s services.

The girl often turned up to school with cuts and bruises.

A police visit to the home due to reports of anti-social behaviour found it was in “atrocious state, with rotting food, used nappies and clothing items strewn across the floor.”

Police concerns that drugs were being used at the home led to a social work assessment, but high caseloads meant it was not completed within the timeframe.

The outcome was to step down the management of the family and the review report said: “Unfortunately, this was based on observation and discussion with their mother during visits and makes no mention of whether their mother had the mental capacity to make these changes or understand why they needed to happen.”

Two days later, the ambulance was called to the home, to reports from the mother that the girl had been playing with a cigarette lighter and had been on fire as she went from the living room to the kitchen. The girl was found in the bath, with burns to her chest and abdomen.

Review recommendations included more training for staff to work with people with learning difficulties and better transfer of safeguarding records.

Chris Robson, chairman of Norfolk Safeguarding Children Partnership, said: “Our thoughts are with these children, who thankfully are now safe and receiving the care and support that they need.

“Although there is much we can learn from these cases, it is important to recognise that there was some really good practice.

“For example, the decision to hold a child protection medical in the case of AG no doubt prevented further suffering and may even have saved his life.

“Neglect is a particularly difficult area because everyone has a different perception of what it is and when to intervene.

“Professionals want to build on family’s strengths and give them opportunities to make positive changes for their children, recognising that there is a lasting impact on children when they are removed from their families and come into care.

“As a partnership, making further improvements to how we identify, prevent and tackle neglect is one of our top priorities and we are working on a new strategy to further strengthen practice.

“There are a range of measures taking place to further strengthen safeguarding practice and help professionals to better understand the risks and challenges facing children and families.

“In social care, professionals are now exploring wider family networks to build on the support and strengths that exist within families.

“There is also a new intensive and specialist support service which frontline staff can call on to provide extra help to families on issues such as domestic abuse and substance misuse.

“Work is also taking place to strengthen family support attached to schools, promoting attendance and preventing exclusion.”