Technology in Social Work: Practice example - Child Protection Information Sharing project (CP-IS)

• CP-IS helps protect children and unborn babies on child protection plans or in care by improving information flow between social workers and NHS professionals
• The £8.3m NHS Digital project alerts a child's social worker to possible abuse by informing them if a child appears at an ‘unscheduled' care setting anywhere in England
• Around one third of an estimated 120,000 eligible children are currently on the system

ACTION

Inadequate information sharing between agencies is cited as a contributory factor in nearly 60 per cent of serious case reviews into the death or serious injury of a child following abuse or neglect, according to a 2013 NSPCC study.

CP-IS covers children and unborn babies who are in care or on a child protection plan. It was made available for local authorities and NHS sites in November 2014, two years after a business plan was drawn up by the Department of Health, which transferred responsibility for it to NHS England in April 2013. Operated by NHS Digital with £8.3m from NHS England until March 2018, it enables authorised staff within "unscheduled" NHS settings such as emergency departments, out-of-hours GPs, walk-in centres and minor injury units to quickly and securely share non-clinical information with social care staff about vulnerable under-18s presenting there, triggering potentially lifesaving discussions with social workers about a child's risk.

When a vulnerable child - or a woman pregnant with a baby on a protection plan - presents at an unscheduled NHS setting in an area covered by the scheme, the computer informs the clinician about the child's care or child protection status, together with the contact details of their social worker, as well as details of previous appearances at unscheduled care settings. An alert is also generated on the local authority's system, informing the social worker of the child's attendance there.

The system helps highlight abuse that can otherwise be masked by parents or carers moving between different health services. "They may live in Manchester, but when there's a medical issue that needs to be dealt with, they will drive across the border to Liverpool," explains senior responsible officer Val Nugent, who has led the project since August 2015. "This is about using technology more effectively to enable an additional layer of protection for children, through a good flow of information between these two key agencies.

"The real beauty of this system is that it will build up a picture for social care professionals, who will then be able to see 25 episodes of care. This is powerful, as normally professionals wouldn't be able to draw all this together. So they'd see a broken rib in isolation, and wouldn't be able to see that two weeks ago, the child also presented with a dislocated shoulder."

CP-IS builds on the technology that children's social care departments already use: 92 per cent use a software data system that is compatible, enabling the necessary changes to be made to connect their IT system with that of participating NHS settings. NHS Digital supports local authorities on all areas of technical implementation. A key piece of preparatory work for authorities is getting the NHS numbers of children they are working with onto their system and to train frontline practitioners in making best use of CP-IS. Nugent estimates it will cost authorities and health settings an average of £10,000 to go live, which could be more or less, depending on factors including their IT resources, broadband connectivity and whether a systems upgrade is required.

In illustrating how the system is helping protect children and young people, she cites the example of an unconscious and unaccompanied 17-year-old brought into an emergency department following an overdose. On check-in, a flag appeared on the system showing she was in care, and pregnant with a child on a protection plan. She showed no visible signs of pregnancy. Clinicians responded to this information by adjusting their treatment plan to protect her unborn child.

NHS staff contacted the duty social worker, discussing the safest place for the teenager to stay, deciding together to keep her in hospital overnight. The following morning, her social worker discussed her condition with health workers, visiting her in hospital to support her return home.

An estimated 40,000 of around 120,000 children and unborn babies in care or on child protection plans are now on the CP-IS system, through the participation of 34 local authorities and 23 NHS trusts, including 74 separate settings.

"We've started to build up clusters; groupings of authorities going live around the same time, which makes it much more powerful, because they're sharing information across borders," explains Nugent. She adds that she is "really excited" about Kent recently going live, an authority that she says is of great strategic importance as the gateway for unaccompanied asylum-seeking children from Calais.

"Once children are allocated their care plan, they'll be on the CP-IS system and because not all of them will be housed in Kent, they'll go to other areas and have a flag in the system in different parts of the country," she explains.

NHS Digital aims to get 80 per cent of English councils and NHS unscheduled care settings live by March 2018.

IMPACT

Key to the evaluation of CP-IS will be showing evidence that it leads to more rigorous safeguarding practice and improved clinical outcomes for children.

Other measures will include the number of notifications passing between local authorities and unscheduled NHS care settings and the number of these that otherwise would not be picked up by local safeguarding processes.

The evaluation will also estimate the cost savings achieved, through reduced administration. Another measure will be a reduction in the number of serious case reviews citing poor communication between social workers and NHS professionals as a factor.