1. Dr Lindsay Logie Dr Charlotte Kirk Dr Lesley Ross
“It’s good to talk” How IT systems can assist Interagency Communications in Managing the Risks in cases of Child Protection.
Dr Lindsay Logie
Dr Charlotte Kirk
Dr Lesley Ross

2. Background NHS Lothian CP team changed in Jan 2015 Central Hub:
Team of Consultant, SASG, trainee Doctor and CPA nurse advisers
All health Interagency Referral Discussions (IRDs)
Specialist advice and assessment for all children thought to be at significant risk of harm
Tertiary medical examinations by consultant and trainee

3. Impact Health team: Other agencies (Police, Social Work):
Travel (away from base)
Workload
But... team work and support
Other agencies (Police, Social Work):
Less local knowledge
Less consistency of decision making
Children may have to travel for examinations

4. But everything is not equal..
Edinburgh
eIRD
Ability to share information live including medical opinion
future proof?
East/Mid/West
No shared documentation
Difficulties in interagency communication
Proposed roll out of eIRD
Endless discussions over last few years

5. E-IRD Other Children aged between 3 and 6y
Not attending school and nursery
Background of older half siblings in care
Parental learning disability and substance misuse
Baby boy
Poor development, hygiene and weight gain
Poor engagement with HV
Mum vulnerable and depressed
House “unfit”

6. E-IRD Other Anonymous referral of increased concern
House unfit- urine mattress, rats/faeces
Children found
Emergency CPO- taken in to care that night
3 IRDs raised over 5 months due to neglect, poor care, not engaging with supports
Unable to engage multi-agency partners in level of concern
In June burn to arm- unexplained, untreated

7. E-IRD Other e-IRD facilitated sharing of information with health
Head lice, severe “nappy rash”, possible cigarette burn to one child’s forehead
Sharing of consent & legal proceedings key in planning medicals
Picture of burn

8. E-IRD Other All children seen for Joint Paediatric Forensic medicals
Improvement evidenced with basic care and hygiene
Evidence of severe neglect and physical abuse, possible sexual abuse.
Further IRD
Presented to RHSC with severe facial bruising
History of punishment of sibs
Into care, frozen emotions improved slowly, gained weight, development improved

9. E-IRD Other Immediate access to background information
Ability to write with clarity about medical concerns/opinion
Information shared between agencies, with direct access to senior practitioners
Verbal exchange of information, collation of a series of events, not as clear
Potential misinterpretation of medical opinion by other agencies in discussion

10. e-IRD the future Stand alone-sits in “DMZ”
E-IRD funded by Edinburgh CPC – not secure. No SLA
Monopoly - maintained by e-Health but only one developer can adapt it
Server and software needs to be updated every 3 to 5 years – no formal provision for this
e-IRD has become fundamental part of CP work
Key risk for CCH Paperlite project – long term secure storage of complex 3rd party information required for CP work

11. e-IRD future solutions?
Consider a new SLA across Lothian to include police, NHS Lothian and councils. This should include:
Funding for regular update of server and software (£5000 / 5 yr for server plus update of sequel server software)
eHealth to develop a support service for eIRD application (developer average salary £32,000 )
Making e-IRD a sustainable long term project
Paperlite- Server for storing CP sensitive documents electronically in addition to e-IRD
Requirement for accurate documentation for court cases, SCRs in the future
Consider a new SLA across Lothian to include police, NHS Lothian and all councils. This should include
Agreement to fund regular update of server and software per 5 yr for server plus update of sequel server software)
? Employ part of a developer (av salary £32,000 – contribute to this?) to learn from Jamie about application – this knowledge can then be spread amongst ehealth.
This makes eIRD a sustainable long term project – if 4 CPC contributing across Lothian cost will not be more than about £6000 per year.