Message on a bottle

The Director of Nursing, NHS England and Deputy Chief Nursing Officer for England reflects on the implementation of the Child Protection Information Sharing system.

In 2009, I spent some time in one of the poorest areas of the Mid-West of America where children faced immense challenges.

I vividly remember seeing milk bottles with pictures of missing children on them. Children were in school one day, gone the next.

Some charities had people working in a limited care system and would spend days, weeks and months looking for children, often with little resource and often with no success.

It brings home how in England in 2017 we are fortunate to be implementing Child Protection – Information Sharing (CP-IS) – which is helping us to identify if a child is at risk of harm.

CP-IS is a national digital solution, connecting IT systems together so that staff in social care teams and front line NHS organisations can securely share information relating to children and young people who are known to local authorities (LAs) in England.

It means that when a child who is Looked After or on a Child Protection Plan presents at an unscheduled care setting, like an emergency department (ED) or minor injury unit:

  • the health team is alerted that they are on a plan and has access to the contact details for the relevant social care team
  • the social care team is automatically notified that the child has presented, and
  • both parties can see details of the child’s previous 25 presentation at unscheduled care settings in England.

This is enabling professionals to work more closely together and build a more complete picture of a child’s interactions with health and social care services. It is helping them to identify patterns of behaviour and to carry out earlier interventions for those who are most vulnerable and at risk.

As with the USA, we know some children at risk of harm are likely to be more mobile and addresses can change frequently. We also know that a child facing abuse is more likely to present at different, unscheduled settings to seek care when needed.

CP-IS tells healthcare staff if a child is the responsibility of the residing local authority or if the child comes from a different area. And it automatically alerts social workers when a child in their care presents at an unscheduled care setting anywhere in England. So if a child at risk attends an ED in Rochdale but resides in Hackney, a notification and relevant communication can still take place with the social worker in Hackney.

Dave Watson, Head of the Safeguarding Unit at Hampshire County Council, describes how CP-IS automatic notifications are helping to protect children when they present for care in other parts of the country;

“Since November when we went live in this area, we’ve received around 500 notifications about children that have presented at unscheduled health settings. And some of those notifications have come from settings that we just wouldn’t have otherwise known about. They have come from places like Leicester, Milton Keynes, and West London and the presentation of those children previously would have been completely invisible to us.

“The CP-IS notification alerts the case holding social worker and the team so they know that presentation has happened. That then adds to our assessment processes, it adds to the understanding of what’s happening in that child’s life, and allows us to better safeguard them.”

I am proud to lead this project for NHS England, working alongside NHS Digital, our delivery partner. CP-IS is currently being rolled out to all LAs and NHS unscheduled care and maternity settings in England.

61 LAs and 185 unscheduled health settings are already actively using CP-IS. We are quickly increasing uptake and the ability to offer more protection to children across England. More than 75,000 children already have the added level of protection that CP-IS provides and more than 1,500 notifications are passing between health and social care sites every month.

The project has its challenges. There are 152 LAs using 15 different computer systems, 95% of which have a compliant system with CP-IS capability. There are in excess of 1,200 NHS funded, unscheduled settings, such as EDs, walk in centres, urgent care centres and maternity settings. These settings use more than 75 different computer systems, a challenge in itself, but we are working rapidly to ensure they all achieve accreditation with CP-IS functionality.

A further challenge is to continue to align the intentions and commitment of every relevant professional, manager and leader across health and social care in England to prioritise the implementation of CP-IS.

NHS organisations are required to implement CP-IS in accordance with the standard NHS contract. Safeguarding professionals across England, working within Clinical Commissioning Groups (CCGs) are supporting the implementation of CP-IS. Commissioners need to work across health and social care to ensure this contractual obligation can be fulfilled.

We all have a duty to protect children, and particularly the most vulnerable in our society who need our protection.  And so I ask that leaders of every Sustainability and Transformation Plan, CCG, LA, and NHS funded provider, and every chair of local children’s safeguarding boards, actively look at the progress being made across their areas to implement CP-IS.

This solution is ours for the taking, it’s on your doorstep and it’s far more than a bottle of milk with a child’s face on it.

Hilary Garratt

Hilary Garratt CBE, BSc, MSc, RGN, SCPHN (RHV), PGCE is the Deputy Chief Nursing Officer NHS England and NHS Improvement.

Hilary leads the implementation of a range of national programmes that focus on safeguarding vulnerable people and programmes that support the professional development and leadership of the nursing profession.

Hilary is a registered Nurse and Health Visitor, with 36 years’ experience of working in clinical, public health and Executive leadership roles in the NHS. Hilary has held a number of Executive Director posts across both commissioning and provider organisations in addition to holding and Deputy Chief Executive post for both. Hilary has been working at National Director level for the last 7 years.

In addition to her professional life, Hilary enjoys volunteering at the front line and also for the third sector. From 2013 – 2017 Hilary worked for BBC Children in Need as a committee member that undertook grant making for the North of England. Hilary also engages in hands on volunteering, working with the homeless and other vulnerable groups in her home city.

Hilary received a CBE in the 2017 New Years Honours for services to Nursing and her national work to safeguard some of the most vulnerable people in society. In 2018 Hilary was nominated as one of the country’s 400 Women of Achievement and Inspiration.

Follow Hilary on Twitter: @HilaryGarratt.