Children's Wellbeing and Schools Bill

Written evidence submitted by Fatherhood Institute (CWSB132)

Children’s Wellbeing & Schools Bill

Bill Committee consultation

Executive summary

We recommend an amendment to the Bill to require NHS England to scope and pilot father-child data linkage, in support of the introduction of a ‘single unique identifier’ for children . Cross-referencing of key information about both parents in children’s birth and health records would improve child safeguarding and additional benefits.

1. Introduction

1.1 We welcome t he Bill ’s goal of introduc ing a new information sharing duty and a ‘single unique identifier’ (SUI) for children, to support improved information sharing across systems for the purposes of safeguarding children and promoting their welfare - with a regional pilot to test the feasibility of using children’s NHS number as a consistent identifier across children’s services.

1.2 However the Bill , in its current form , overlooks an important, related issue on which there has been a frustrating lack of progress – the linkage of data about fathers and children.

1.3 Neither father-child nor mother-child data linkage are mentioned explicitly in the Bill. But mother-child data linkage is assumed, since it happens universally as a service requirement – and as things stand, this provides the only clear and consistent route through which services are able to identify , from a child’s health record alone , one of its parent s .

1.4 In the UK, mothers’ NHS records are systematically linked to birth notifications by midwifery services [1] . But n o such linkage happens for fathers and children . So even though 95% of biological fathers are at the birth and 95% of parents jointly register the birth (giving them, like the mother, Parental Responsibility) , a child’s birth record and health record do not include any information about their father .

2. Rationale

2.1 This absence of father- data is problematic in three key ways:

o 2.1.1 First, i t acts as an obstacle to maternity and other, subsequent services taking a routine, holistic view of the key adults around the child - such as their physical and mental health and alcohol or drug use. A key benefit for the child of including information about the father would be the gathering of information about his genetic contribution to many physical and mental health risks: biological fathers contribute half of the baby’s genome, so knowing biological father AND biological mother health history is HIGHLY relevant for health practitioners [2] . From a safeguarding perspective , too, the absence of father data contribute s to the invisibility of the small minority of fathers who may pose a risk to their children . In o ur 2021 evidence review for the Child Safeguarding Practice Review Panel on non-accidental injury of babies by fathers [3] we highlighted "the lack of data on parental characteristics and risk factors in administrative databases and case records, especially in health services, and particularly on fathers’ characteristics and circumstances " . The Panel’s report The Myth of Invisible Men went on to conclude:   "There is an undoubted imperative to extend our knowledge base about men who physically abuse babies....  we do not ‘see’ them or understand them well enough or in sufficient detail… Health records for babies only allow the inclusion of one adult (the mother), so records relating to fathers are held separately and family records cannot be seen in a joined up and connected way ".

o 2.1.2 Second , the lack of father -child data linkage is a key factor in services’ failure to identify, engag e with and provid e appropriate support , services and interventions to fathers . R esearch shows that n ew fathers do not access services or feel adequately supported [4] and from the service point of view, if a father is unnamed on the child’s records, he is extremely unlikely to be engaged with, assessed and/or, where necessary, challenged. Including father s’ information on birth notifications would better enable targeted service offers to new fathers after the child is born – providing opportunities to reduce this unmet need . Indeed, the simple fact of having to collect relevant data (however minimal) from fathers , as a matter of routine , would in itself act as a ‘mini-intervention’ on which more father-inclusive practice could build .

o 2.1.3 Third, f ather-child data linkage could also transform research about children and the reasons for their varying outcomes , supporting the development of large national administrative datasets to provide reliable information on fathers and children in vulnerable populations, including those who may have been excluded from, or chosen not to engage with, bespoke research surveys. This can reduce selection or non-response biases compared to primary data collection and make it easier to follow study participants over time since they do not need to engage with study team members. Linked mother-baby data has already enabled research identifying , for example, links between pre-pregnancy psychosocial risk factors and lower birthweight [5] ; exploring the relative risks of birth induction and expectant management [6] ; and analysing children’s exposure to maternal mental illness [7] , and the cost of this to the NHS [8] . Linked father-child data has the potential, as the foundation stone of safer, more responsive, father-inclusive services and interventions, to enable similar analyses about paternal characteristics and risk factors. However, current administrative datasets for research purposes rarely include data about fathers . An important example is the Education and Child Health Insights from Linked Data Mother-Baby (ECHILD-MB) Database , created by University College London, the Department for Education and NHS England. This dataset bringing together information about health, education and social care for all children in England born since September 1984 includes information about their mothers but not their fathers. It captures 87.3% of all births and 87.7% of all live births in England, and as of 2023, includes mothers aged 12–37 and their children aged 0–24 years. Since this dataset is increasingly being used to replace or supplement bespoke research surveys, including UKRI’s multi-million Early Life Cohort and Adolescent Health Study, it is imperative that father-baby linkage enables father-data to be added.

3. Recommendation

3.1 We and a team of UCL researchers who carried out a  scoping review  of fathers in administrative health records agree that a key step forward would be linkage of birth notifications and/or birth registrations to fathers' NHS numbers.

3.2 Others have previously approached NHS England/NHS Digital on this issue, only to receiv e the response that there is no capacity to introduce such a change . Even the Child Safeguarding Practice Review Panel's  Myth of Invisible Men  report, and subsequent Ministerial letters back to the Panel, have not been sufficient to achieve better child-father record linkage in the safeguarding system.

3.3 We therefore recommend an amendment to the Bill to require NHS England not just to develop and test the child SUI in isolation but, at the same time, to scope and pilot father- child data linkage options.

23 January 2025