Re: communicating over child protection concerns

[Guest guest]

I think from my initial skimming of the press reports , that the

Climbie report has picked up this issue and recommends that there

should be a database on children at risk, and that the DPA should

be amended if necessary.

Priority: normal

From: " W Coles " <colesew@...>

Date sent: Fri, 31 Jan 2003 17:12:08 GMT0BST

Subject: communicating over child protection concerns

Send reply to:

[ Double-click this line for list subscription options ]

I gave a seminar on preventing shaken baby syndrome yesterday to an

ACPC with a really good mixed audience, hvs, paeds, police, army,

Sure Start, HA staff etc. I found it quite disconcerting that at my

suggestion that all parties with an interest in prevention in the

community should be pooling information about a case causing concern

where there may be the potential for a abuse. I was told, I think by

an hv, 'We are not allowed to speak to others about a case without

the parents/client consent'. Just what is the data protection act

protecting? Not vulnerable infants it would seem.

Have others had difficulty in practice like this? I am thinking also

of cases where there is domestic violence.

Dr Coles RGN, RHV, BA, PhD

Research Fellow

University of Wales College of Medicine

Department of Child Health, Community Section

First Floor, Academic Centre

Llandough Hospital

Cardiff CF64 2XX

Telephone 029 2071 6933/5479

e-mail ColesEW@...

[Guest guest]

Hi

In some of the work I have been doing not only that directly involving

children, I have often found people have a fear of sharing client

information perhaps,as you found,they feel they must or believe their

employing organisations requires them to work in partnership with the client

and patient and share with them first. However Ialsosee a lot of

professional protection of information and the need to share with the

patient/client first or the data protection act used as the excuse.

As we all know in the Children ACt 1990, the child's needs are seen as

paramount and so for me this means if it is information about a child's

safety then it must be shared regardless. I have not always found this

happens and there is evidence in some national child protection as well as

chapter 8 and single assessment reviews that deaths or severe injury has

occured because of a failure to share relevant information. Other things I

have picked up is a failure to recognise the need to and also a written

decision to share but then a failure to follow thorough and do so.

I wander if the ACPC in this case but PCT etc in other cases need to make

it clear follwoing Climbie that information must be shared and that as part

of clinical governance they caheck it.

Margaret

communicating over child protection concerns

> I gave a seminar on preventing shaken baby syndrome yesterday to an

> ACPC with a really good mixed audience, hvs, paeds, police, army,

> Sure Start, HA staff etc. I found it quite disconcerting that at my

> suggestion that all parties with an interest in prevention in the

> community should be pooling information about a case causing concern

> where there may be the potential for a abuse. I was told, I think by

> an hv, 'We are not allowed to speak to others about a case without

> the parents/client consent'. Just what is the data protection act

> protecting? Not vulnerable infants it would seem.

>

> Have others had difficulty in practice like this? I am thinking also

> of cases where there is domestic violence.

>

>

>

> Dr Coles RGN, RHV, BA, PhD

> Research Fellow

> University of Wales College of Medicine

> Department of Child Health, Community Section

> First Floor, Academic Centre

> Llandough Hospital

> Cardiff CF64 2XX

>

> Telephone 029 2071 6933/5479

> e-mail ColesEW@...

>

>

[Guest guest]

Confidentiality and the sharing of information has been used by professional

groups to

enable them to exert their agendas; why just children's needs..it should be

people

and we need to remember that services exist for them, not the other way

round. What we are facing is a time-expired

professional control paradigm that takes us into these senseless and painful

places to show

us that it is time to change. My notes should not be the property of the

secy of State..they should be MY property..

there is nothing in there unless I exist and engage services and those

services are for MY benefit. Furthermore,

I pay for them, not the Government..the Government is a broker/manager of

what WE, as citizens, pay in the

ever increasing spiral of payments and taxes. It is time for all this to

change.

Roll on a web-enabled 24x7 128 bit encrypted data haven, I say, in which

there are 'files in the sky' generated for all people in the UK and to which

all the relevant

professionals, users and carers have access (including me to my own

file)..this

WILL solve the ludicrous proliferation of thousands of servers in lots of

different places, all run by different IT depts

and suppliers and the inability of each to talk to the other.

This is the proper legacy for that dear sweet child; the only people who

will block it

will be the trad. power brokers going on about 'patient confidentiality'

(which, in truth

leaks all overy NHS building I have ever visited)and the ethical moralisers

who love

to throw these arguments around and who do not have to work in the day to

day dysfunctional

system themselves and of course felons and paedophiles!

Re: communicating over child protection concerns

Hi

In some of the work I have been doing not only that directly involving

children, I have often found people have a fear of sharing client

information perhaps,as you found,they feel they must or believe their

employing organisations requires them to work in partnership with the client

and patient and share with them first. However Ialsosee a lot of

professional protection of information and the need to share with the

patient/client first or the data protection act used as the excuse.

As we all know in the Children ACt 1990, the child's needs are seen as

paramount and so for me this means if it is information about a child's

safety then it must be shared regardless. I have not always found this

happens and there is evidence in some national child protection as well as

chapter 8 and single assessment reviews that deaths or severe injury has

occured because of a failure to share relevant information. Other things I

have picked up is a failure to recognise the need to and also a written

decision to share but then a failure to follow thorough and do so.

I wander if the ACPC in this case but PCT etc in other cases need to make

it clear follwoing Climbie that information must be shared and that as part

of clinical governance they caheck it.

Margaret

communicating over child protection concerns

> I gave a seminar on preventing shaken baby syndrome yesterday to an

> ACPC with a really good mixed audience, hvs, paeds, police, army,

> Sure Start, HA staff etc. I found it quite disconcerting that at my

> suggestion that all parties with an interest in prevention in the

> community should be pooling information about a case causing concern

> where there may be the potential for a abuse. I was told, I think by

> an hv, 'We are not allowed to speak to others about a case without

> the parents/client consent'. Just what is the data protection act

> protecting? Not vulnerable infants it would seem.

>

> Have others had difficulty in practice like this? I am thinking also

> of cases where there is domestic violence.

>

>

>

> Dr Coles RGN, RHV, BA, PhD

> Research Fellow

> University of Wales College of Medicine

> Department of Child Health, Community Section

> First Floor, Academic Centre

> Llandough Hospital

> Cardiff CF64 2XX

>

> Telephone 029 2071 6933/5479

> e-mail ColesEW@...

>

>

[Guest guest]

Liz and , you are right; Laming says:

" Throughout this Inquiry it was said repeatedly that when there is

professional concern about the welfare of a child, the free exchange of

information is inhibited by the Data Protection Act 1998, the Human

Rights Act 1998, and common law rules on confidentiality. The evidence

put to the Inquiry was that unless a child is deemed to be in need of

protection, information cannot be shared between agencies without staff

running the risk that their actions are unlawful. This either deters

information sharing, or artificially elevates concern about the need for

protection each of which is not compatible with serving well the needs

of children and families. Clearly these matters are complicated. There

must be a balance struck between the protection of a child and the right

to privacy. "

As a result, he recommends that:

" Recommendation 17: The Government should issue guidance on the Data

Protection Act 1998, the Human Rights Act 1998, and common law rules on

confidentiality. The Government should issue guidance as and when these

impact on the sharing of information between professional groups in

circumstances where there are concerns about the welfare of children and

families. "

Our new NMC Code of Conduct changed the wording about confidentiality

from the code used under UKCC. The NMC were probably aiming to make it

clearer by adding a sentence that says:

" 5.4 Where there is an issue of child protection, you must act at all

times in accordance with national and local policies "

Rather paradoxically, by tying the Code to other policies, they may have

re-inforced the anxieties felt by registrants faced with the Data

Protection Act etc.

It does state quite clearly that, if consent (to divulge information)

cannot be obtained for whatever reason

" 5.3 . . . disclosures may be made only where they can be justified in

the public interest (usually where disclosure is essential to protect

the patient or client or someone else from significant harm) "

This does tend to make disclosure sound like an option to be avoided

where possible, rather than one that, in some circumstances, should be

required as the preferred option. Perhaps the NMC will look at this, in

the light of Laming? I can feel a letter coming your way, Maureen! best

wishes

MEERABEAU ELIZABETH wrote:

>I think from my initial skimming of the press reports , that the

>Climbie report has picked up this issue and recommends that there

>should be a database on children at risk, and that the DPA should

>be amended if necessary.

>

>

>

>

>

>

>

[Guest guest]

Thanks . I will have a different audience next week for a

workshop and will see what is happening elsewhere but Igot the

feeling that no one was challenging this interpretation of the Data

Protection Act to allow professionals to act in the child's interest.

We shall see what transpires from the Laming Recomendation

On 2 Feb 2003 at 13:27, Cowley wrote:

> Liz and , you are right; Laming says:

>

> " Throughout this Inquiry it was said repeatedly that when there is

> professional concern about the welfare of a child, the free

exchange of

> information is inhibited by the Data Protection Act 1998, the Human

> Rights Act 1998, and common law rules on confidentiality. The

evidence

> put to the Inquiry was that unless a child is deemed to be in need

of

> protection, information cannot be shared between agencies without

staff

> running the risk that their actions are unlawful. This either

deters

> information sharing, or artificially elevates concern about the

need for

> protection each of which is not compatible with serving well the

needs

> of children and families. Clearly these matters are complicated.

There

> must be a balance struck between the protection of a child and the

right

> to privacy. "

>

> As a result, he recommends that:

>

> " Recommendation 17: The Government should issue guidance on the

Data

> Protection Act 1998, the Human Rights Act 1998, and common law

rules on

> confidentiality. The Government should issue guidance as and when

these

> impact on the sharing of information between professional groups in

> circumstances where there are concerns about the welfare of

children and

> families. "

>

> Our new NMC Code of Conduct changed the wording about

confidentiality

> from the code used under UKCC. The NMC were probably aiming to make

it

> clearer by adding a sentence that says:

> " 5.4 Where there is an issue of child protection, you must act at

all

> times in accordance with national and local policies "

> Rather paradoxically, by tying the Code to other policies, they may

have

> re-inforced the anxieties felt by registrants faced with the Data

> Protection Act etc.

>

> It does state quite clearly that, if consent (to divulge

information)

> cannot be obtained for whatever reason

> " 5.3 . . . disclosures may be made only where they can be justified

in

> the public interest (usually where disclosure is essential to

protect

> the patient or client or someone else from significant harm) "

>

> This does tend to make disclosure sound like an option to be

avoided

> where possible, rather than one that, in some circumstances, should

be

> required as the preferred option. Perhaps the NMC will look at

this, in

> the light of Laming? I can feel a letter coming your way, Maureen!

best

> wishes

>

>

>

>

>

>

> MEERABEAU ELIZABETH wrote:

>

> >I think from my initial skimming of the press reports , that

the

> >Climbie report has picked up this issue and recommends that there

> >should be a database on children at risk, and that the DPA should

> >be amended if necessary.

> >

> >

> >

> >

> >

> >

> >

>

>

>

>

[Guest guest]

Thanks Margaret and Chris

I was also concerned on the level of preventing child abuse in that if all

agencies are to be enrolled in a campaign they are likely to become

aware of information which should be shared to protect a vulnerable,

or potentially vulnerable child. Here I mean non statutory agencies

in the community such as church, toddler clubs or anywhere where

infants and parents go.

On 2 Feb 2003 at 7:23, Margaret Buttigieg wrote:

> Hi

>

> In some of the work I have been doing not only that directly

involving

> children, I have often found people have a fear of sharing client

> information perhaps,as you found,they feel they must or believe

their

> employing organisations requires them to work in partnership with

the client

> and patient and share with them first. However Ialsosee a lot of

> professional protection of information and the need to share with

the

> patient/client first or the data protection act used as the excuse.

>

> As we all know in the Children ACt 1990, the child's needs are seen

as

> paramount and so for me this means if it is information about a

child's

> safety then it must be shared regardless. I have not always found

this

> happens and there is evidence in some national child protection as

well as

> chapter 8 and single assessment reviews that deaths or severe

injury has

> occured because of a failure to share relevant information. Other

things I

> have picked up is a failure to recognise the need to and also a

written

> decision to share but then a failure to follow thorough and do so.

>

> I wander if the ACPC in this case but PCT etc in other cases need

to make

> it clear follwoing Climbie that information must be shared and that

as part

> of clinical governance they caheck it.

>

> Margaret

>

> communicating over child protection concerns

>

>

> > I gave a seminar on preventing shaken baby syndrome yesterday to

an

> > ACPC with a really good mixed audience, hvs, paeds, police, army,

> > Sure Start, HA staff etc. I found it quite disconcerting that at

my

> > suggestion that all parties with an interest in prevention in the

> > community should be pooling information about a case causing

concern

> > where there may be the potential for a abuse. I was told, I think

by

> > an hv, 'We are not allowed to speak to others about a case

without

> > the parents/client consent'. Just what is the data protection act

> > protecting? Not vulnerable infants it would seem.

> >

> > Have others had difficulty in practice like this? I am thinking

also

> > of cases where there is domestic violence.

> >

> >

> >

> > Dr Coles RGN, RHV, BA, PhD

> > Research Fellow

> > University of Wales College of Medicine

> > Department of Child Health, Community Section

> > First Floor, Academic Centre

> > Llandough Hospital

> > Cardiff CF64 2XX

> >

> > Telephone 029 2071 6933/5479

> > e-mail ColesEW@...

> >

> >

[Guest guest]

and friends,

I have been musing about the lunchtime school-based Clinics in rural

Oxfordshire, described in this week's Nursing Standard: Peckham &

Carlson, NS 29/01/2003, 33-38. Clearly we need low-threshold,

non-stigmatising, multi-agency services for a range of vulnerable young

people, but I am not sure the Oxfordshire " Bodyzone " gets to the parts

that others cannot reach... what do school nurses in Senate think ?

Woody.

On Mon, 03 Feb 2003 15:02:20 GMT0BST W Coles

<colesew@...> wrote:

> Thanks Margaret and Chris

> I was also concerned on the level of preventing child abuse in that if all

> agencies are to be enrolled in a campaign they are likely to become

> aware of information which should be shared to protect a vulnerable,

> or potentially vulnerable child. Here I mean non statutory agencies

> in the community such as church, toddler clubs or anywhere where

> infants and parents go.

>

> On 2 Feb 2003 at 7:23, Margaret Buttigieg wrote:

>

> > Hi

> >

> > In some of the work I have been doing not only that directly

> involving

> > children, I have often found people have a fear of sharing client

> > information perhaps,as you found,they feel they must or believe

> their

> > employing organisations requires them to work in partnership with

> the client

> > and patient and share with them first. However Ialsosee a lot of

> > professional protection of information and the need to share with

> the

> > patient/client first or the data protection act used as the excuse.

> >

> > As we all know in the Children ACt 1990, the child's needs are seen

> as

> > paramount and so for me this means if it is information about a

> child's

> > safety then it must be shared regardless. I have not always found

> this

> > happens and there is evidence in some national child protection as

> well as

> > chapter 8 and single assessment reviews that deaths or severe

> injury has

> > occured because of a failure to share relevant information. Other

> things I

> > have picked up is a failure to recognise the need to and also a

> written

> > decision to share but then a failure to follow thorough and do so.

> >

> > I wander if the ACPC in this case but PCT etc in other cases need

> to make

> > it clear follwoing Climbie that information must be shared and that

> as part

> > of clinical governance they caheck it.

> >

> > Margaret

> >

> > communicating over child protection concerns

> >

> >

> > > I gave a seminar on preventing shaken baby syndrome yesterday to

> an

> > > ACPC with a really good mixed audience, hvs, paeds, police, army,

> > > Sure Start, HA staff etc. I found it quite disconcerting that at

> my

> > > suggestion that all parties with an interest in prevention in the

> > > community should be pooling information about a case causing

> concern

> > > where there may be the potential for a abuse. I was told, I think

> by

> > > an hv, 'We are not allowed to speak to others about a case

> without

> > > the parents/client consent'. Just what is the data protection act

> > > protecting? Not vulnerable infants it would seem.

> > >

> > > Have others had difficulty in practice like this? I am thinking

> also

> > > of cases where there is domestic violence.

> > >

> > >

> > >

> > > Dr Coles RGN, RHV, BA, PhD

> > > Research Fellow

> > > University of Wales College of Medicine

> > > Department of Child Health, Community Section

> > > First Floor, Academic Centre

> > > Llandough Hospital

> > > Cardiff CF64 2XX

> > >

> > > Telephone 029 2071 6933/5479

> > > e-mail ColesEW@...

> > >

> > >

[Guest guest]

Oh good. Currently many children living in domestic violence situations are

not even known to HV's because of the DPA - thus support is not possible.

communicating over child protection concerns

> Send reply to:

>

> [ Double-click this line for list subscription options ]

>

> I gave a seminar on preventing shaken baby syndrome yesterday to an

> ACPC with a really good mixed audience, hvs, paeds, police, army,

> Sure Start, HA staff etc. I found it quite disconcerting that at my

> suggestion that all parties with an interest in prevention in the

> community should be pooling information about a case causing concern

> where there may be the potential for a abuse. I was told, I think by

> an hv, 'We are not allowed to speak to others about a case without

> the parents/client consent'. Just what is the data protection act

> protecting? Not vulnerable infants it would seem.

>

> Have others had difficulty in practice like this? I am thinking also

> of cases where there is domestic violence.

>

>

>

> Dr Coles RGN, RHV, BA, PhD

> Research Fellow

> University of Wales College of Medicine

> Department of Child Health, Community Section

> First Floor, Academic Centre

> Llandough Hospital

> Cardiff CF64 2XX

>

> Telephone 029 2071 6933/5479

> e-mail ColesEW@...

>

>

[Guest guest]

Through increasing user involvement and blowing the traditional control

freaks

from the medical fraternity out of the still waters of confidentiality.

128 bit data encryption is tighter even than Tony Blair's anus?

Confidentiality is a wonderful theoretical word used by all these players to

control the agenda.

It is not THEIRS to own control, or even Hippocrates's..it is MINE!

Doing it the way we do it now results inf 20-30% doctor time being wasted

looking for notes/people asking duplicated questions/

receptionists asking in full view whether " it is urgent " and appalling

diasters a la Climbie.

Caldicott Guardians..I'm sorry..is this the 21st century NHS or MIddle

Earth?

Chris

Communicating over child protection concerns

On 3 Feb 2003 at 15:39, wrote:

> Re communicating over child protection concerns

>

The fact that info that can protect a child is withheld is bad. But it

isn't easy to

persuade indpendent contractor trades that it's a good idea because we

haven't

acknowledged their fears and conflicts. We all came through the fear

ourselves as

HVs to function in our jobs. But GPs (with the odd exception) clearly

haven't. They

still have this 'family doctor' idea, the Hippocratic Oath and its secrecy

still has a

cultural importance, plus they fear conflict and simply being wrong in a

litigious

society. The Sally e case won't have reassured them much on the latter

point.

I'm sorry to say that Clinical Governance isn't the answer. There is no

real control at

all over doctors or dentists unless they are employed by the NHS or it's in

the

GMS/GDS contract. I think we need to use appropriate tools for the task and

for this

one, how do we know about the non-disclosure anyway? It's evident in

failure to

attend case conferences and contribute to Part 8 reviews or care plans.

Courts tend

not to subpoena GPs in care proceedings. Do we have any real sanctions?

ly

no. We can only act if there is clear evidence of breach of the GMS

contract, and

barely then.

How do we handle this in the real world of primary care?

.

[Guest guest]

I am aware of a really good analysis of the whole legal framework for

confidentiality and communication of concerns in the annexes to the

Carlile report - available from the website of the Welsh Assembly.

Unlike Climbie, this wasn't a review of a case which failed. It was

a review of whole NHS responsibilities for safeguarding children.

The review team benefitted from the advice of an experienced

specialist barrister in child protection, Ruth Henke. She wrote the

annex.

I think this is clearest explanation of the legal position I ever

read. It demolishes arguments against sharing information if there

is a a child at risk of serious harm. The position of a child about

a 'child in need' is more difficult.

I'll find the annex and load it for reference later.

H.

>

> >I think from my initial skimming of the press reports , that

the

> >Climbie report has picked up this issue and recommends that there

> >should be a database on children at risk, and that the DPA should

> >be amended if necessary.

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

The item in the Carlile review is entitled 'Caldicott in context'.

I've got problems accessing the section alone (ignorance, I'm

afraid!) and so I'm trying to put the document in the Files section.

For those without web access to this discussion, the link to the site

is :

http://www.wales.gov.uk/subihealth/content/keypubs/pdf/safeguards_text

-e.pdf

Hope this helps!

H

> >

> > >I think from my initial skimming of the press reports , that

> the

> > >Climbie report has picked up this issue and recommends that

there

> > >should be a database on children at risk, and that the DPA

should

> > >be amended if necessary.

> > >

> > >

> > >

> > >

> > >

> > >

> > >