Memorandum by the e-Assessment in Child
Welfare research project, located at the University of Huddersfield
and part of the Economic and Social Research Council e-Society
Programme
Dr Christopher Hall and Dr Sue Peckover (Huddersfield
University), Professor Andy Bilson (University of Central Lancashire),
Professor Brid Featherstone (Bradford University) and Professor
Sue White (Lancaster University)
SUMMARY
This submission reports findings of research
on the implementation of new technologies to support information
sharing and assessment in child welfarethe children's database
and the common assessment framework. There has been concern that
the database constitutes an increase in surveillance of families
and an invasion of privacy. Our findings are that the implementation
of the technologies has been slow with some reluctance by professionals
and agencies. There are problems about accuracy, consistency and
consent. The use of new technology also provided challenges to
working in partnership with families. The extension of the initiative
with the implementation of a national database, ContactPoint,
poses major concerns about privacy and constitutional rights.
1. This submission reports the findings
of research by the e-Assessment in Child Welfare project, located
at Huddersfield University, part of the ESRC e-Society programme.
The project has monitored the implementation of the Information
Sharing and Assessment initiative in four local authorities over
the last two years, including two of the pilot projects. Our findings
focus on how these technologies are being used by professionals
in their everyday work.
2. INFORMATION
SHARING AND
ASSESSMENT
The Inquiry into the death of Victoria Climbié,
(the Laming report), like many that preceded it, highlighted problems
in the way that professionals in child welfare communicated. They
often worked in isolation, had a partial view of the needs of
and risks to Victoria and made unwarranted assumptions about the
role and actions of other professionals. Had information available
to these professionals been coordinated, a more holistic picture
of Victoria might have emerged and the need to intervene been
recognised. In response the Government introduced the Children
Act 2004 and the "Every Child Matters" initiative, which
implements new technologies to promote information sharing and
assessment of children: the children's database (sometimes called
the Child Index) and the Common Assessment Framework.
3. The database has been the subject of
critical comment in Parliament, the media, amongst children's
charities and academics. Some consider it an inappropriate, costly
and disproportionate response which will not protect children.
Too much information will be collected but without extra services.
Others see it as an invasion of family privacy and an increase
in surveillance more generally. There are particular concerns
about the security of confidential information.
4. THE CHILDREN'S
DATABASE
The children's database is required under s.12
of the Children Act 2004. It contains basic information on all
children in an area, details of their parents and carers, school
and GP. It also includes contact details of targeted services
being provided and the opportunity for professionals to record
a "cause for concern". It is accessible to all professionals
with criminal records bureau clearance. It does not include confidential
information or case records, but indicates where such information
exists. However it has been noted that displaying children's contact
with services and "concerns" constitutes confidential
information. It was piloted in 11 local authorities, but, because
of technical and information sharing problems, only three have
established a working index. A national database (called ContactPoint)
is planned for 2008.
5. THE COMMON
ASSESSMENT FRAMEWORK
(CAF)
The CAF has received less comment. This is a
standard assessment form to be used by all child welfare professionals,
which can be e-enabled. It encourages professionals to assess
children in terms of their personal development, parenting and
family environment, under 19 headings. Children and parents' comments
and their consent to share the assessment are recorded. The existence
of a CAF is entered on the children's database. It is seen as
an early assessment of a child's needs and concerns, to be completed
mainly by schools, GPs, health and early years' professionals.
The CAF was piloted in 12 local authorities and is being developed
in others.
6. CONTEXT OF
ISA
The development of these technologies should
be understood in terms of changes in child welfare policy more
generally. Social policy commentators have observed the expansion
of state intervention with children. "Every Child Matters"
heralds a more universal view, focusing on "children with
additional needs", rather than children "at risk"
or "in need", as in earlier legislation. The Government
aims to identify and track around a third of children who require
interventions beyond universal services. By intervening at an
earlier stage, it is hoped that more appropriate services can
be provided and more serious problems prevented. However, such
identification requires a massive system of assessment and information
exchange. The use of information and communication technologies
(ICTs) can be seen as constituting increased surveillance of children
and families. In particular, information at early stages of "concern"
is being recorded and shared, some of which might be termed "low
level"; for example children with literacy difficulties who
did not warrant a holistic assessment. In our research some professionals
were instructed to complete CAFs routinely, sometimes with insufficient
knowledge of the child. The database includes all children, yet
only a small proportion have needs which warrant multi-professional
attention. This raises the question whether these are proportionate
responses.
7. Whilst child welfare organisations have
always maintained large amounts of information on children, these
initiatives encourage and require information to be managed and
exchanged in new ways. The ICTs in the pilot projects in our research
have limited functionality, only able to track individual children.
However, it is not clear what options will be built into ContactPoint,
and if it will facilitate opportunities for "data matching
and profiling" (combining data sets to predict behaviour)
or "function creep" (data collected for one purpose
are used for another).
8. INACCURACIES
Our research has identified wide data inaccuracies.
In terms of the children's database, there are both technical
and practice problems. A child's record was established by matching
data from various sources, health, social services, education
and because of differences in basic informationnames, house
numbers, birth dates etcthis created multiple records for
some children and missed others. Children who frequently change
address or school are often particularly vulnerable.
9. There was inconsistency over when a professional
should indicate their involvement with a child on the database.
For those in contact with large numbers of children, for example
teachers or GPs, it is not clear at what point their involvement
constitutes more than a universal service. The pilots demonstrated
that when parents were consulted before making an entry, some
refuse. Also some "sensitive services", like counselling
or mental health workers, did not record their involvement. All
these omissions and errors meant that a professional looking up
a child's record did not see all those involved. In our research,
the local knowledge of workers was often more accurate than the
database. This created a view that the database was not useful
and led to less use and hence more inaccuracy.
10. INCONSISTENT
PRACTICES
We found considerable variation in the use of
the CAF, both between and within local authorities. Some agencies
see it as an internal assessment for the professional, the family
and the agency. Others see it as a referral to pass concerns on
to targeted services. Different uses create different approaches
to how it is completed. The former approach is more likely to
be completed with the family and represents agreement about a
shared view of the child. The latter aims to persuade other agencies
to become involved, not necessarily representing families' points
of view.
11. Information sharing is often assumed
to be straightforward: for the writer it is seen as uncontested,
discrete and easily written. For the reader it is seen as accurate,
consistent and meaning the same thing. However we found professionals
balancing dilemmas of working in partnership with children and
parents and sharing concerns with other agencies. In both cases
information sharing was a strategic activity.
12. CONSENT AND
PARTNERSHIP
Obtaining informed consent to share CAF information
is difficult with electronic systems. Our research found no evidence
children or parents had access to their electronic records, and
consent to record professional involvement was not clear. Some
professionals completed CAFs with children and parents, but, particularly
when used for referral purposes, only around half reported consent.
As these technologies are extended, they limit the active participation
of children and parents in key decisions across increasing parts
of service provision.
13. The database and CAF concern individual
children and there is limited ability to address wider issues
in terms of families and communities. The limited functionality
of the database does not link siblings' records. The CAF asks
about parenting, not the problems faced by parents. To assume
that CAF databases have more accurate information about services
than families may encourage a general distrust of parents.
14. THE FUTURE
IMPLEMENTATION OF
CONTACTPOINT
A number of constitutional issues are raised
by current proposals for ContactPoint. This includes removing
the need for consent and common law rights to confidentiality
with regard to data held on it. We are also aware of the draft
guidance on shielding (hiding) data in ContactPoint which makes
it difficult for individuals (eg those involved in domestic violence)
to know of the need or to request that their data should be shielded.
The proposed threshold is that data can be withheld only if it
is likely to cause "significant harm". With potentially
a wide range of professionals accessing ContactPoint there are
insufficient safeguards. Whilst the data are limited, malevolent
access raises serious potential misuses (eg grooming a child,
locating estranged children or stalking a professional).
15. Given this impact on constitutional
rights and potential misuses, ContactPoint needs to demonstrate
that it serves the greater good either through demonstrating general
benefits to a wide range of children or substantial benefits to
a smaller number. As with other commentators we question whether
the specific benefits of the system are likely to be achieved
sufficiently to outweigh possible problems of confidentiality,
inaccuracy or potential abuses of the system.
6 June 2007
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