Yesterday saw The Times reporting plans for a new Child Protection Information System, which aims to link up and log data on all children’s visits to A&E or an out of hours (OOH) GP with social services’ at-risk registers. (Log-in required, both for the Times story, and hopefully for the new system as well.) The Department of Health confirmed the story, which has also been followed up by the Guardian, BBC, Telegraph, Sun, Independent and EHI (via my NHS news and comment feed @ImpatientNHS).
This system is there to do some of what ContactPoint, an index of all children in England scrapped by the coalition government in 2010 along with ID cards, was meant to do: help alert NHS staff, social workers and police to each others’ involvement in a child, to aid co-ordination over child protection. It is not a straight replacement, being much more limited in scope, and on a first look the system has a better chance of success. However, it still faces challenges.
On the bright side, unlike ContactPoint, the Child Protection Information System isn’t planning to cover all children – only those using A&E and OOH services. The project’s lead is Dr Simon Eccles, a consultant at Homerton Hospital who is already taking a pragmatic approach to renewing the NHSmail email service. And the department (apparently correcting the Times report) expects hospitals to install this from 2015, not by then, which is rather more realistic.
While a limited scope, good leadership and a realistic timescale are good signs, there are problems. Privacy is an issue – tackled in the Times by Big Brother Watch’s Nick Pickles (log-in required) – although perhaps an addressable one. This is partly because hospitals already keep their own records – children don’t get treated anonymously – and partly because of the smaller scope. A fear with ContactPoint was that, through covering every child (except, notoriously, those of celebrities and MPs) it would become the obvious target for anyone wanting data on any specific child for any reason. The limited scope means that this will probably not be the case here, but set against that are the facts that the most innocent A&E and OOH admission will put a child on the system, and also the NHS’s poor record on infosecurity.
And then there’s the complexity. The reported software development budget for the Child Protection Information System is £8.6m. It’s not clear if this includes integration with trusts’ A&E systems and on-site implementation, but it’s worth noting that the whole budget works out as less than £54,000 for each of the 160 acute trusts in England (and that ignores the OOH providers). The great lesson of the National Programme for IT was, don’t assume England’s hospitals all work the same way and that one system can easily be introduced in many places. More like, don’t assume one system can easily be introduced in any places.
Of course, the trusts won’t all use different software. But according to the database of acute trust software run by my employer EHI Intelligence, there are 25 different suppliers of A&E software to acute trusts in England (as well as in-house systems) and even the largest supplier has less than 30% of this fragmented market. Furthermore, some of those using the same supplier will be split between different software and versions.
The new system could avoid integration by standing alone from the hospital’s IT, but that would be likely to add to the staff time needed for each admission. So purely on IT integration and implementation the system looks like a lot of work, and perhaps rather more money than appears to be in the budget. It will be interesting to see the detailed plans from Dr Eccles and his colleagues.