National alert system to pick up early signs of abuse
When a child visits an emergency department regularly, staff will generally start to suspect whether they could be treating a victim of abuse. But if a child is taken to different hospitals around the country, it can be difficult to spot the pattern
When a child visits an emergency department regularly, staff will generally start to suspect whether they could be treating a victim of abuse. But if a child is taken to different hospitals around the country, it can be difficult to spot the pattern.
However, emergency nurses across England are now being increasingly supported to uncover victims of abuse at an early stage through a new national alert system.
The Child Protection – Information Sharing (CP-IS) system is intended to alert clinical staff to those at risk of abuse or neglect by connecting emergency departments, out-of-hours GPs, walk-in centres and maternity units with information held on vulnerable children by local authorities.
The £7 million NHS England system was launched to local authorities and NHS sites in north east London, north west England, Wakefield and North Tyneside last September. By 2018, it is expected that 80% of the more than 1,200 unscheduled care settings in England will be using it.
Most local authorities are expected to be uploading information to the system by the end of this year, according to developers at the Health and Social Care Information Centre (HSCIC).
The system focuses on people with child-protection plans, pregnant women whose unborn children have protection plans and children given looked after status by local authorities. In March 2012, this accounted for more than 103,000 children.
Under the CP-IS system, NHS staff will be alerted to children at high risk when demographic details are looked up during the standard registration process at NHS unscheduled care settings.
At this point, an indicator flag will automatically appear on the screen if the registering child has a child-protection plan in place or has looked-after-child status. This will happen as soon as basic, routinely requested information is entered into the local IT system.
The dates of when plans begin and end, and child-protection team contact details are shared to improve communication between social care and the NHS.
Any query from healthcare professionals and where they work will be recorded automatically, and shared with the NHS and local authorities.
NHS England and the HSCIC say the information will improve risk assessments and child-protection decisions by providing healthcare professionals with reliable access to better supporting information.
Serious case reviews
The change is being implemented after serious case reviews found that children living in abusive and neglectful home environments are likely to be moved across different local authority boundaries.
Under the new system, staff from the NHS and local authorities will be able to tell if children attend emergency departments or urgent care centres frequently, which can be an indication of neglect or abuse.
The system should also save time as health and local authority teams will no longer have to produce lists or enter data manually, and help improve intervention to prevent ongoing abuse or neglect. The content of child-protection plans is not revealed on the system, however.
RCN Emergency Care Association chair Janet Youd, is a consultant nurse in emergency care at Calderdale and Huddersfield NHS Foundation Trust, part of the first wave to introduce the system.
‘Traditionally in an emergency department, three visits from a child would start to raise questions on whether there are any safeguarding issues,’ she says. ‘But, if they are being taken to different emergency departments, we wouldn’t know.
Not just local
‘The brilliant thing is that CP-IS is not just local information so, if a child is staying with their grandmother, for example, we will be able to check with their home service if a protection plan is in place.
‘But the key thing is that this does not replace existing processes for assessing and checking vulnerable children and it is only as good as the information being put there by the local authority. This supplements decision making.’
That said, Ms Youd notes that staff at her department have found that the system seemed to have difficulties identifying children with hyphenated names, as spaces and hyphens all need to be in the correct place to locate the relevant file. There could also be challenges with locating asylum-seeking children who have no NHS number.
RCN professional lead for children and young people Fiona Smith says the college has been involved with the development of the CP-IS.
‘The feedback we have had is that this is extremely helpful and useful. There used to be a lack of communication and knowledge as to whether children are vulnerable, but CP-IS is extremely good.’