1. Child Protection – Information Sharing (CP-IS) Project Homerton and InterSystems
Child Protection-Information Sharing Programme
We all have a duty to protect children.
Does what it says on the tin, this solution will enable the sharing of child protection information from Local Authorities to the NHS with a return message indicating that a child has been seen in an unscheduled care setting.
We will go into details about what the solution is and who has been instrumental to get ministerial approval, we will demonstrate how it will work in practice and what the benefits will be to a child.
CP-IS Project Team
Version 1.0 Sep 2014

2. What is CP-IS?
An NHS England sponsored programme to develop an information sharing solution that will deliver a higher level of protection to children who visit NHS unscheduled care settings
Design to share information for those children who are subject to a Child Protection Plan, Looked After Children and any pregnant woman whose unborn child has a pre-birth protection plan

3. Background – ‘Why’
Dr Dan Poulter Parliamentary Under secretary of state for health
Serious Case Review: Victoria Climbe, Baby P
Poor implemented local procedures and sharing of information has lead to these serious case reviews due information not being available to health
Fragmented information sharing between Health and Social Care – localised information, manual input
The Child Protection – Information Sharing project is an NHS England initiative that, when implemented, will help to deliver the Department of Health policy "Making sure health and social care services work together".
The Government reinforced its commitment to child protection on 10 June 2010 in announcing an independent review to be conducted by Professor Eileen Munro. A key focus of that review will be on improving the interaction between professionals dealing with children in different sectors, including health.
CP-IS aims to start bridging these s gaps and deliver the capability of sharing key information between Health and Social Care on vulnerable children by developing an information sharing solution
Sponsored by NHS England and delivery commissioned to HSCIC
The project has engaged with key stakeholders and colleges/professional bodes
Lord Laming

4. How will it work – Information Flow
1. Local Authority record information locally with Social Care system. Automatic submission to CP-IS upon creation or amendment of status of child
Uploads
Healthcare worker
Social worker
Query
Clinical System
CP-IS
Children’s services
system
Query response
Access History
CP-IS functionality within the National SPINE – data store
Child protection information recorded locally within social care following a case conference
Initial upload LA will upload information on their cohort of Children to CP-S, thereafter there will be an automatic submission to CP-IS, upon creation or amendment of status of child. Overnight update to NHS Spine
When a child’s information is looked up in the local health setting a check is made and any CP-IS information is displayed.
When the CP-IS record is looked at by the Health professional an audit of the event is recorded and returned to the local authority and other health workers looking at the child
This information is only held for children who are looked after or on a child protection plan, not for all children visiting unscheduled care. The above details are then made available to the local authority responsible for the child. They can also be accessed by subsequent NHS users viewing the child's child protection information.
The access event log will help to highlight the children that have received unscheduled medical care across local authority boundaries. It will also help to provide clear and current indicator information to the NHS user viewing the child's details.
CP-IS is not there to replace existing safeguarding policies and processes, but to support and provide up to date information which is not routinely available to aid in decision making and assessment
2. NHS user will query CP-IS and will be notified if there is known information for Child Protection for the child
3. Access History Alert will be created when an NHS user queries CP-IS

5. Child Alert information on National spine
NHS Number (Primary Identifier)
Local Authority Name
Local Authority Code
Local Authority Emergency Duty Team Telephone Number
Local Authority Office Hours Telephone Number
Child Protection Plan Start Date
Child Protection Plan End Date
Looked After Child Start Date
Looked After Child End Date
Unborn Child Protection Plan Start Date
Unborn Child Protection Plan End Date
NHS number: is the primary identifier to share this information between social care and health and the LAs will have to populate the cohort of children's records with the NHS number and maintain this by working with the health professionals responsible for the children's care.
Data Item Format
NHS Number format (Numerical )
Local Authority Child Identity Number Text
Given Name Text
Family Name Text
Date of Birth DD/MM/YYYY
Source Organisation Name Text
Source Organisation Code Alpha Numeric
Source Organisation Telephone No. Numerical
CPP Start Date DD/MM/YYYY
CPP End Date DD/MM/YYYY
CPP Delete Date DD/MM/YYYY
Looked After Child Start Date DD/MM/YYYY
Looked After Child End Date DD/MM/YYYY
Looked After Child Delete Date DD/MM/YYYY
Unborn Child CPP Start Date DD/MM/YYYY
Unborn Child CPP End Date DD/MM/YYYY
Unborn Child CPP Delete Date DD/MM/YYYY

6. CP-IS – ‘Information Sharing Solution’
Where will be shared
The solution will be available in the current scope in these settings: (Phase 1)
This is where is deemed that clinicians are working with little or no information about the child in these areas – biggest benefit with prompt and easy access to relevant information for a child that may help in the decision making processes to identify and act on risks in a timely way
Unscheduled care settings:
Emergency departments / A&E
Walk-in centres
Minor injury units
Maternity Units
Ambulance
GP out of hours
Paediatric wards
It is known that some LA routinely share information with their Health Partner, but it often limited to CPP only, only for Local area and relies on manual input into local systems

7. Benefits for NHS staff
Improves the assessment of children presenting in unscheduled care settings through access to better supporting information.
Deliver more focussed communication between social care and health concerning these groups of children, leading to improved intervention to prevent the ongoing abuse or neglect of a child.
Builds a stronger more transparent relationship with social care workers due to information being shared on the system.
Save time as NHS staff will no longer need to manually produce lists or enter data manually

8. Homerton CP-IS implementation
Reggie Marriage, Named Nurse for Safeguarding Children
Steven Ouko, Systems Integration Manager

9. CP-IS project was launched in Dec 2012 at Homerton
Incorporating hospital and community health services, teaching and research

10. Homerton CP-IS Inception
Go-Live 17th November 2014
14 months to define Homerton solution
Procure, Implement, Change / Train
1st meeting with HSCIC 14-Mar-2013
Planned Go live May-2014
Options available then
Integrated 
SCRa, (via smartcard access)
Incorporating hospital and community health services, teaching and research

11. InterSystems HealthShare Spine Mini Service enabled Homerton to implement CP-IS
Maintain Seamless Patient Record
All new systems and solutions need to integrate with existing Electronic Patient Record (EPR) system
Operationally
Existing Alert system is EFFECTIVE, why change?
No disruption to clinical work
No additional training required
Incorporating hospital and community health services, teaching and research

12. April 2014 CQC rated Homerton A&E Outstanding
~ 3,500 Staff
63,782 Inpatient / Day Case / Regular Attenders
318,866 Outpatients appointments
April 2014 CQC rated Homerton A&E Outstanding
Could be removed as you have provided a lot more details about Homerton but there some facts that you could include highlighted in red
118,837 A&E attendances
28,698 are children up to age 18 years
75% children who attended A&E are residents of Hackney and City of London
Incorporating hospital and community health services, teaching and research

13. Homerton Alert System A&E Paediatric Assessment Form Maternal Form
Customer Electronic Alerting in place since 2010
Two Tier alerts
Demographic banner bar, visible to all
Flowsheet and GenView tab, visible to clinicians
Electronic safeguarding forms
A&E assessment
Maternal Safeguarding
Specialist Safeguarding
Automated safeguarding report
A&E Paediatric Assessment Form
Maternal Form
Specialist Form
Incorporating hospital and community health services, teaching and research

14. Alert Information Visible to All
Demographic Banner
Alert Information Visible to All
Child subject of child protection plan
Age: 11 years (*)
Child with safeguarding concerns
Age: 5 years (*)
Unborn subject of a child protection plan
Age: 21 years (!)
Incorporating hospital and community health services, teaching and research

15. Information Visible to Clinicians only
Safeguarding Detail
Safeguard
Information Visible to Clinicians only
Incorporating hospital and community health services, teaching and research

16. A&E Paediatric Assessment Form
Safeguarding Forms
Maternal Form
A&E Paediatric Assessment Form
Specialist Form
Brief Homerton setup Before go into options detail
Safeguarding Alerts available on EPR through a custom process. Two tier - custom demographic banner and GenView tabs. Envy of many and working well.
EPR is Cerner Millennium (NB: Outside national programme with local development team)
Ensemble as the TIE (flexibility, accumulated expertise and possibility of Spine Mini Services)
Incorporating hospital and community health services, teaching and research

17. Updated Safeguarding form
Added a new field to capture LAC information
Referral forms to Children Social Care updated with new NHS No field
Incorporating hospital and community health services, teaching and research

18. Current situation No LAC data
Safeguarding children’s team receives weekly / monthly child protection list
Safeguarding Forms completed manually
Only Hackney data available
No LAC data
Use to set alerts for children with child protection plans
Midwives set alert for unborn – carried forward when baby is born
Incorporating hospital and community health services, teaching and research

19. Homerton CP-IS Workflows
Reggie’s Clinical workflow
Steven’s Technical workflow
Like to include this, as I will be saying that I presented my initial vision of how CP-IS information could be integrated with our existing flagging system and Steven produce his workflow to show how he can make it happen with InterSystem
Incorporating hospital and community health services, teaching and research

20. CP-IS is LIVE at Homerton as from 17th November 2014
Incorporating hospital and community health services, teaching and research

21. CP-IS is integrated/embedded into Homerton Alert system
Ready to receive information from the National Spine
Incorporating hospital and community health services, teaching and research

22. Child Alert information on National SPINE
Child attends A&E, OPD, admitted or patient data modified
Real time checking of NHS numbers via Mini-spine
Child alert received from National Spine Check
CP-IS child alert automatically populated onto the safeguarding form with details of Type of Alert, Named of LA and Contact details. The new flag *A* is set
Clinical staff sees flag *A*
If required, use SMARTCARD to access more health information on the spine
Alert safeguarding children team
Share information with community health professionals GP / HV / SN
Check EPR for details
Carry out assessment and treatment
Make contact with local authority
Safeguarding process
Incorporating hospital and community health services, teaching and research

23. Demographic banner New Red Flag *A* visible to all staff
Child subject of child protection plan or Looked After Child
Age: 11 years *A*
Child with safeguarding concerns
Age: 5 years *A*
Unborn subject of a child protection plan
Age: 21 years (!)
Incorporating hospital and community health services, teaching and research

24. Safeguarding details Type of alert Date of alert Name of LA
Contact details of Local Authority
Incorporating hospital and community health services, teaching and research

25. No Child Alert information on National SPINE
Child attends A&E, OPD, admitted or patient data modified
Real time checking of NHS numbers via Mini-spine
No child alert received from National Spine Check
Usual assessment, treatment, and follow-up
If Safeguarding concerns identified
Follow-up the Safeguarding procedure
Incorporating hospital and community health services, teaching and research

26. New Alert created on the demographic banner
Child attends A&E, OPD, admitted or patient data modified
Real time checking of NHS numbers via Mini-spine
No NHS number match received from National Spine check
NHS number tab will display
# NOT TRACED
Clinical staff sees
‘# NOT TRACED’
Include in assessment
Re-checking of demographic details
If safeguarding concerns identified,
follow safeguarding process
No safeguarding concerns,
Refer to GP/HV or No further action
Incorporating hospital and community health services, teaching and research

27. Demographic banner NHS No: # NOT TRACED
Incorporating hospital and community health services, teaching and research

28. CP-IS information integration with Homerton EPR system Supports the clinicians in the decision making process and encourage communication with children social care but not override the assessment of the child’s needs
Local Authorities expected 80% to be sharing information in 2015
From initial vision to final product!!
Midwives to share NHS Number with LA
Incorporating hospital and community health services, teaching and research

29. Outcome CP-IS information Clinical knowledge & experience
Child / Unborn
is Safeguarded
CP-IS information
Clinical knowledge & experience
Sound decision making
Robust safeguarding arrangements
Incorporating hospital and community health services, teaching and research

30. Further information
Fact Sheet F.A.Q. Progress map News Contact HSCIC CP-IS project team on: Reggie Marriage or Steven Ouko or