Child health and social care data ‘must fit together’

The proposed national child index that will be used to record and share information about the statutory services being used by individual children must be made to fit with the national programme for IT, the government has said.

The government response to a consultation on information sharing databases – also known as child indexes – carried out last winter says: “We [the Department for Education and Skills] shall be working with the Department for Health to ensure that index development and the NHS Connecting for Health (CfH) programme fit together.”

But the short statement on what is seen as an important aspect of the index has been described as “glib” by some of the trailblazer sites currently piloting child indexes within 11 local authorities.

Lucy Rudd, information sharing and assessment manager in East Sussex said: “The statement is a tad optimistic since we don’t really know what the national programme for IT will look like.”

James Randall, ICT manager for Sheffield Safetynet, told EHI: “Somebody somewhere has woken up to the fact that this is a problem and needs to be resolved. But this is a bit glib.”

The issue was not technical, he said. “I think we can leave it up to the techies to solve the problem of how health professionals can gain access to a local authority database.”

The core issue would be data matching, he said, with information for the index coming from local authority and health records.

Randall said: “The biggest problem will be knowing that we are talking about the same child as we create the index. We need to start taking some very careful steps and build in processes and procedures for cases where we match incorrectly or fail to match.”

CfH declined to provide an update on meetings it has been holding with trailblazer sites in recent weeks or on work underway to make the fit.

CfH issued a statement which said: “The Department for Education and Skills is working with the Department of Health to ensure that index development and the National Programme for IT, which is being delivered by NHS Connecting for Health, fit together.”

The idea of child indexes was proposed in Lord Laming’s inquiry into the death of Victoria Climbié who was tortured and eventually murdered by her great aunt and the great aunt’s boyfriend. Lord Laming argued that a mechanism for sharing information about children’s contacts with different services could flag up those at risk of harm. The idea was taken forward in the 2004 Children Act.

The index is not a case management tool. It provides demographic data as well as contact details for professionals who have had contact with the child.

The consultation covered recording contact with “sensitive” health services, who should have access to this information and how practitioners will record their concerns about a child.

It says that practitioners in services such as sexual health, child and adolescent mental health or substance misuse will have to gain consent before adding their details to the index.

These details will in turn be visible only to a narrow range of database users, such as social workers or lead professionals.

While this will satisfy many health professionals who were concerned that routine disclosure would deter children and young people from using some services, others have criticised it.

Rudd said: “There appears to be an expectation that health information is sensitive, full stop, end of question. Our experience when we have asked kids is that they are fine about the details being recorded.”

Enshrining health information as more sensitive than other information made working relationships between practitioners more difficult and ignored the sensitivities of families, she added.

“It is wrong in principle and nonsense in practice,” she said.

Further guidance on establishing national coverage of indexes in England is expected in the autumn, subject to approval of the business case and identification of necessary resources.