Requests for direct access to NCRS resisted

The Care Record Development Board (CRDB) has resisted requests for agencies concerned with child protection to draw information directly from the NHS Care Records Service and for every attendance by children at accident and emergency departments to be logged on the Child Index.

Speaking at a briefing during the board’s annual conference, chair, Harry Cayton, said conversations with the Department for Education and Skills had revealed “some conflicts of values” over data sharing for the Child Index, the database designed to co-ordinate information about children at risk of harm.

He said initially the approach was: “We want to be able to draw down data from the NCRS.” But this was declined, said Cayton, though, of course, the NHS wanted to support a process for the protection of children.

The negotiated process allows NHS staff to see into the Child Index from their NHS computer terminal and to input data without the Index being able to get back into the NCRS. A technical fix has been worked out to allow this to happen, Cayton said.

A further suggestion that every child attendance at accident and emergency should go on the Index was also refused on the grounds that it would be burdensome to the NHS and “a terrible social message to send to parents,” said Cayton.

Decisions about whether or not to record suspicions about abuse on the Child Index will be a matter of clinical judgement – as they are in the non-electronic world currently.

Asked whether parents’ permission would be sought for recordings, Cayton replied: “Paediatricians will say ‘yes’ it’s good practice to tell parents [about concerns]. It’s good practice but not a legal requirement.” Later in the process of formalising concerns about a child, parents have to be told.

Child protection specialists are not the only people interested in the potential of the NCRS to provide useful information, it seems. The security services have also been knocking on Cayton’s door and he made it clear that they had been told to go away.

“The security services were hopeful they would get access to the demographic element of the record and would be able, without asking, to check most-recent addresses,” he said.

He said there had also been discussions with the police who “traditionally and appropriately” had come to A&E departments when they were looking for people involved in serious crime who might be injured.

Cayton made it clear that disclosures of information from the NHS to the police would still require the same processes as they do currently. Connecting for Health clinical lead, Dr Simon Eccles, who is also an A&E consultant, said disclosures were dealt with on a personal basis between a senior officer and senior clinician.

Some cases have to go to court for a ruling that disclosure would be in the public interest.