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Child protection database project plagued by delays

NHS Digital’s child protection information sharing project is suffering from low and slow uptake both among NHS trusts and local authorities

The project to introduce a child protection information sharing system (CP-IS) across all of health and social care in order to protect vulnerable children has been extended to March 2019 as it struggles with low adoption rates.  

The scheme, which was first launched in 2012 by then health minister Dan Poulter, aims to enable staff in unscheduled care settings to quickly identify if a child presenting to A&E or minor injuries units has a child protection plan in place, or is in the care of social services.

However, the project has been plagued by difficulties since its inception. Originally, the plan was for the system to have its first wave or roll-outs taking place in a series of local authorities and NHS trusts in 2015, with 80% of them using the database by the end of March 2018.

NHS Digital’s May 2017 board papers show that by summer 2016, it became clear “the project was failing to achieve its targets and would struggle to meet them”.

“Although it was right to set ambitious targets and aim for them with total commitment, a review of the programme by NHS Digital and NHS England, with support from the Cabinet Office Infrastructure & Projects Authority (IPA) review, recognised that new milestones should be set for the project and the approach to delivery reconsidered,” the board papers said.

The new targets set now require only 65% of local authorities and 45% of NHS settings to be live with the system by next March. By March 2019, it is envisioned that 90% of local authorities and 80% of NHS settings will be live.

“Any local authority or NHS sites that are not live at that point will be managed to live in the subsequent year through the Implementation and Business Change team.”

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The project has also struggled with reduced funding. The original business case was for £8.6m, but this was reduced in the final business case to £6.77m until March 2018. So far, NHS England has spent £5.8m on rolling out the system, but it’s now expected that a tolerance acceptance report will “gain approval for the additional spend”.

“It is estimated that to extend the programme by a year would incur costs of approximately £2.1m for an additional year of funding, and this will be evaluated in more detail as part of the Tolerance Exception Report process,” the papers said.

Joining up health and social care

Some of the main challenges in deploying the system have been that health and social care has historically not been joined up, which resulted in “early technical challenges”, as well as a lack of funding in the original business case. 

“The original business case included funds for social care suppliers to incorporate CP-IS into their systems, but no funds for NHS suppliers or funds for Local Authority or NHS business process change and project management,” the papers said.

“The original case also underestimated the number of project implementation resources required, which was increased in 2016 and has contributed to increased deployment. This situation has been exacerbated by subsequent local authority reductions in funding and NHS winter pressures.”

Currently, around a thousand alerts go through CP-IS each week. Speaking at UK e-health week, NHS Digital’s director of digital transformation Beverley Bryant said that uptake needs to increase, and that the organisation “needs to drive uptake across health and care”.

She said that where the system is in use, it has proved to be very beneficial. Two months ago, she said, a young woman was brought in by ambulance after taking an overdose. By using CP-IS, the clinicians was able to find out that she was a looked-after child herself, that she was pregnant and that the unborn child has a child protection plan in place. Through CP-IS, the team looking after her care could quickly alert the social care team.

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