Our clinical director and consultant in emergency medicine at Leeds Teaching Hospitals NHS Trust, Haidar Samiei, explains why the importance of child protection information-sharing (CP-IS) cannot be underestimated.
With over 120,000 young people in England assessed as vulnerable or at risk of abuse, the importance of child protection information-sharing (CP-IS) cannot be underestimated.
As an emergency medicine consultant, I see everything from simple cases to life-threatening conditions. Potential child safeguarding cases can range from the obvious to the extremely subtle and complex. Some are easy to spot when there are clear signs of physical abuse or a known history. Then there are children who come in with complaints that, in isolation, are nothing life-threatening, nothing for the emergency department to treat acutely – but something sets alarm bells ringing. There are also vulnerable unborn children and siblings to consider.
In these cases, I’d find one of our emergency department nurses and share my concerns. With that tiny amount of information, they go off and find out what they can and report back to me. This process relies on us knowing the right organisation to contact, the specific questions to ask and the correct procedures to follow, as well as having the time and focus to pursue the information gathering process. It can take hours. In a fast-moving emergency department – where we’re working under unprecedented pressure and have a very short period of time with the child and their family – it’s vital to have a better way of protecting vulnerable children.
The CP-IS is part of a national collaborative programme to share information between services to help provide additional protection for hundreds of thousands of vulnerable children.
Symphony, our emergency care clinical system will be the first to lift CP-IS data and integrate directly into the clinicians’ workflow, alerting staff that they are dealing with a known vulnerable child or young adult before they even start a consultation.
CP-IS allows doctors, nurses and other health professionals across the country to know whether a child has a child protection plan, a pre-birth child protection plan, or is a ‘looked after’ child. It won’t matter which local authority created or updated the plan, all healthcare professionals involved in their care will be able to see the information. For those children attending from another area - often a risk factor - they’ll be able to see crucial information for the first time.
It also allows local authorities and other emergency department clinicians to see where, when and how often a child has been to an emergency department, minor injury unit or other unscheduled care setting anywhere in England.
For me, before I’ve even seen a child, the system will allow me to spot immediately whether they are flagged as vulnerable, and take the necessary steps to safeguard them. I believe it will hugely improve the odds of identifying children as vulnerable when there are no obvious signs of abuse.
Not only that, it will save hours of work a day for hard-pushed clinicians, helping us focus our efforts on helping safeguarding, rather than jumping through hoops to gather information. It means we will no longer have to rely on vague concerns, with the risk of the child falling through the hospital safety net due to lack of time or information. For those children where there isn’t a concern, it will help us offer appropriate care and reassurance to families.
The system won’t replace clinical judgement. Emergency department staff can often be the first to spot early cases of vulnerability or abuse, and this will not change. Instead, it’s a flag to warn us of risk and heighten our senses. As healthcare professionals, we make judgement calls all the time, and our risk tolerance alters depending on the circumstances. Every single member of clinical staff will have – at least once – finished their shift, gone home and worried about a child that they’ve decided wasn’t vulnerable. CP-IS will make it easier to operate in an extremely difficult environment.
Being available in over 65 emergency departments in England through Symphony, will be a huge step forward for CP-IS. The Government wants 80% of England’s local authorities to transmit child protectiondata for CP-IS by March 2018. The pioneering work that we have done to integrate this into an already robust and trusted system will, I believe, create demand among clinicians using other emergency department clinical systems.
When it’s 3am and you’re seeing a child who you suspect may be vulnerable, ask yourself, do I have enough information to make a safe decision? CP-IS will be a huge step forward in arming yourself to do it.