Safety recommendation
HSIB recommends that NHS England, working with relevant stakeholders, reviews the utility of the safeguarding data in the Emergency Care Data Set and agrees a process for assuring the quality of any data to be captured.
Response:
NHS England welcome this report and will work closely with relevant stakeholders to consider how best to implement the recommendations.
For the Emergency Care Data Set the data fields required to collect the safeguarding information already exist, as conformance Indicators https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-sets/emergency-care-data-set-ecds/emergency-care-data-set-conformance-indicators:
- Safeguarding concern
- Injury Intent
- Injury Mechanism
The ECDS dashboard Emergency Care Data Set (ECDS) Dashboard: Time in department - Tableau Server (england.nhs.uk) is active across 187 systems. Systems can access the ECDS dashboard, and various reports can be generated to self-assess themselves, benchmark against data quality and ensure required fields are being populated adequately.
Guides for healthcare workers have been produced to highlight the importance of vigilance in reporting concerns Information Sharing to Tackle Violence | RCEM
Systems responsibilities are mandated in the ‘Safeguarding children, young people and adults at risk in the NHS Safeguarding accountability and assurance framework’ (england.nhs.uk)
NHS England resource the Child Protection Information System Child Protection - Information Sharing (CP-IS) service - NHS Digital already being stood-up within all NHS urgent care settings which contains children on a child protection and / or looked after children plans and there are Phase 2 plans for CPIS within outpatients for was not brought, primary care, community dental and sexual health to roll out by March 2025.
The NHS and healthcare providers have the statutory multi-agency safeguarding Local Area Designated Officer (LADO) requirements as set out in Working Together to Safeguard Children (2018) (Chapter 2 Paragraph 4) and is governed by the Local Authorities duties under section 11 of the Children Act 20004 and the statutory Child Death Overview Process on the untimely death of children Working Together to Safeguard Children 2018.
Actions taken to deliver safety recommendation:
- By December 2023, any Section 17 (child in need), 47 (child protection plan) and CDOP or LADO referrals from emergency departments, PICU or NICU must be shared with Designated Professional at ICB immediately. Progress and assurance: Complete. From November 2023 ICBs began receiving notifications of any NICU / PICU baby with NAI who is also logged on CPIS. In addition, the Child Death Overview Process (CDOP) leads now report directly into Integrated Care Boards (ICBs). This is logged in the NHS Safeguarding Integrated Data Dashboard (NHS SIDD) via the Safeguarding Case Review Tracker (SCRT) since January 2024. Each ICB designated professional is responsible for updating the SCRT.
- By April 2024, each ICB will ensure that the ECDS safeguarding (low grade harm) codes and the BadgerNet (system in Paediatrics and Neonatal Intensive Care Unit (PICU/NICU)) safeguarding codes are routinely and securely shared with the lead ICB assurance officer. Progress and assurance: Complete. NHS Head of Safeguarding is working with our lead consultant for Emergency Medicine and the Data & Analytical Services Directorate to support implementation of this recommendation. The Data and Analytical Services Directorate (new) are undertaking their prioritisation plan for ECDS in mid-April 2024. This will enable sharing of ECDS safeguarding codes.
- To further ensure the routine and secure sharing of BadgerNet safeguarding codes the NHS Head of Safeguarding is reviewing the approach with the Chief Midwifery Officer. Progress and assurance: In progress and action due by September 2024.
Response received on 14 March 2024 and updated July 2024.