A and E database

(226 Posts)
ZebraInHiding Thu 27-Dec-12 14:54:05

http://www.guardian.co.uk/society/2012/dec/27/every-child-accident-emergency-dabatase

I thought they did this anyway? Don't they senda note to your health visitor?

Do you agree with it or do you think it will make people worry more? Whilst I can see the good in it, I worry that kids just won't get taken for help any more. Not sure what the solution is though. sad

MrsJREwing Thu 27-Dec-12 18:39:02

You didn't link to the family falsley accused of munchousens, a few stories down "in the news" who the judge slammed ss.

That fake cancer woman had a personality disorder that manifested in her gaining money by using her child and falsifying dr's letters for dla.

LittleBairn Thu 27-Dec-12 18:40:19

Surely this puts children at risk, people wont take children to A&E when they should in order to avoid a 'visit' from the authorities.

I dread to think what would have happened to my sister and I as children, we both fractured our skulls as tots. Two complete different accidents both happend while alone with my mum ( although I was responsible my my sisters ) there is a high chance that she would have been looked upon suspiciously.

munchauson by proxy is now known as fabricated and is quite rare.

I still think its a good thing to try and protect children. The people who are abusing their children so badly that they have to go to A&E may not be taking them anyway. Saying that its better that they can take them in the knowledge that no one will follow it up if they are taking them to multiple departments so they can carry on abusing their child, doesn't exactly make it better does it?

That fake cancer woman had a personality disorder that manifested in her gaining money by using her child and falsifying dr's letters for dla.

I don't get your point as thats's what Muchausens by proxy is. Pretending your child has an illness that they don't. It can also manifest by physically injuring their child for the same effect.

I think we'll have to agree to disagree on this one!

LittleBairn Thu 27-Dec-12 18:53:38

But it's not always abusive parents who make bad choices. What about good parents who have accident prone children getting investigated. The next time the child has an accident they may decided to stay at home.

Recently I decided not to get an injury checked out because I knew there was a chance they would look at my husband suspiciously. He accidentally shut my arm in a van door, luckily it didn't break but there was a few hours when I was uncertain.

but surely you are more likely NOT to take your child to A & E if you are abusing them?
not attend appointemnts,
and you might ahve appointments in a vareity of spiecaliaties and this way the information of your non attendance would be there.

school and play gorup should be on the ball to notice injuries. etc., non treatment.

MrsJREwing Thu 27-Dec-12 18:58:29

I think she has a personality disorder one where you have no empathy npd/antisocial , you think she has mhbp as you say we will have to disagree.

MHBP or FII is supposed to be rare, about 70 cases worldwide, so why were dozens of people with a rare condition being accused of it, the stats don't fit.

One family won their case against a famous hospital, the hospital withdrew care from a child who was ill, the hospital lost in court, the child is slowly recovering from the damage that hospital did. The hospital is run on charity money and is now appealing that case with charity money. I know this to be true as the charity of our condition has been involved in the case and they told many of us about this case, I also know the family.

prettysunset Thu 27-Dec-12 19:09:32

I think this should've been rolled out without the knowledge of the general public, but then I'm also in favour of identity cards...nothing to hide...

anothercuppaplease Thu 27-Dec-12 19:13:21

If you look at the last two big cases, Baby P and Victoria Climbie, both children had been seen many, many times by different hospitals, GPs, doctors, nurses. THey had also been seen loads of times by social workers. I remember from child protection training that he was seen or visited 60 times by healthcare professionals and social workers.

But, and it's a big but, the individuals in question did not link up with each other. I don't know if a universal 'knowledge management' system or 'information database' would have helped but still, someone has to be there to link up the information together and see the bigger picture.

I think that if this initiative links up with social services' database, all GPs, all A&Es, all out of hour GPs, nurses, HVs then it is a good system but and it's another big but, a group of people somewhere has to be in charge of spotting the patterns of abuse, raising the alarm, and FOLLOW IT UP. Sorry about shouting but this is what happens too often - the abuse is spotted, reported, investigated, but the decision making process to remove a child from their family is too slow and not done effectively. This initiative costs £8.6 million. I wonder how many more social workers could be trained and measures put in place to help not only spot or connect (this is all the database will do) clues that there is abuse, but act upon it...

and stop the cutbacks to social services for starters!

colleysmill Thu 27-Dec-12 19:17:21

Maybe I'm being a bit slow today but are they expecting a&e to notify ss directly or just escalating the information to professionals already involved (GP, hv etc)

Good practice states that any referrals made to ss should be discussed with the family before being made with the exceptions being fabricated illness and if it is felt that any discussion would place a child in significant risk of further harm.

In fabricated illness I understood a and e attendance is only one part of the jigsaw and that usually there are other multiple attendances at services elsewhere.

Often in high profile cases the biggest failing is poor communication between services involved. As services in social care and the nhs become more fragmented with alternative providers being involved I can see this might be one step to manage this but I can understand the misgivings about it.

anothercuppaplease Thu 27-Dec-12 19:22:11

I an not sure but the database would 'flag up' a number of children who are considered 'at risk'. If the family has an assigned social worker, if there is suspected abuse reported elswhere, BBC says 'Under the new system, children arriving at a hospital accident and emergency or urgent care centre will be checked on the NHS computer system. That will clarify whether the youngster is on the register for children considered to be at risk, or in council care. The system is also intended to make it easier for doctors and nurses to see if patients had other emergency admissions elsewhere in the country.'

piglettsmummy Thu 27-Dec-12 19:31:53

I've just read that link to the story about that woman how faked her sons illness! Absolutely awful!! That poor boy shock

LadyMaryChristmas Thu 27-Dec-12 19:32:58

There are measures already in place so why is the Government trying to reinvent the wheel? confused

After the tragic death of Victoria C the then Labour Government introduced the policy 'Every Child Matters', the sharing of information between agencies was a key point to this. The NHS have since attempted to 'upgrade' their IT systems so that hospital A can find out whether a child has been previously admitted to hospital B. In the mean time, when a patient is triaged the staff can see whether there is SS involvement with the family (usually), all previous attendances etc. Once a child is discharged from A&E, even if it's for a cut finger, a letter is automatically sent to that child's GP/HV or school nurse. They do look at them and will speak to the family if there's a pattern. If the hospital staff are concerned about a child who is in the department they contact the the paediatrician in charge of child protection or the child's HV/SS straight away. The GP/HV/School nurse know which children are on the at risk register and they do already share information.

I've no idea whether the current Government have scrapped this, but it sounds to me as though they are trying to take the credit for something that was already there, or have realised that they have scrapped something which benefits children so are bringing it back. It's all bollocks, basically.

Makes me question why they are doing this now? Baby P's death wasn't a recent thing so shouldn't something have been done before now? Vigilance is the key not another hair brained policy. It's the nursing staff who flag issues up, so better training on how to spot non accidental injuries will be far more effective.

colleysmill Thu 27-Dec-12 19:35:27

So working logically currently a+e , ooh etc send a report a notification that you attended (this happens here anyway) and then the GP practice then pass that info on to relevant sw

With the new database they can notify the SW already involved direct?

but lady mary, if this information is on the computer, which it currently -issnt-, instead of expecting paeds to contact ss to ask . the ifnoramtion will be shown on data base

MrsDeVere Thu 27-Dec-12 19:38:29

We need to do something
Parents of abused children do take them to A&E but they tend to delay attendance and have convoluted stories as to why they are there.
This is why training is SO important. A database is useless unless medics are well trained in spotting signs of abuse.

In my area the follow up is woeful. I have complained about it.
I have 5 children. I have been up to A&E more times than I can count. Sometimes you will get a photocopied letter that says (I have ranted about this before on MN)
'We have been trying to contact you about your recent attendance at A&E, with no success ,please contact xxxxxxx at xxxxx CC'

This is sloppy safeguarding. They do not bother to contact (there is always someone at home, I know they didn't phone), you are asked to call a nursery nurse at the local children centre who is obviously not medically trained, when you call them you cannot get through and they do not return your call.

BUT procedure has been followed, a box has been ticked. This is worse than doing nothing IMO.
AND stating that they have been trying to contact you without success can look very bad on record if a family has already had intervention from SS.

I have concerns about the database. I have done a lot of safeguarding training with my LA. TBH I was bloody appalled at the attitude of the facilitators and will not be doing it with the again. Any attempt to discuss the challenges faced by parents of disabled children was met with a 'oh so you don't think disabled children deserve protection?' hmm

No, I was trying to have a conversation about children who self harm, who may need restraining, who eat compulsively, who have no sense of danger, who wander in the night etc etc.
What happens when you come up against a 23 year old doctor with NO experience of what it is like living with a child with challenging behaviour?

Will the database kick off a fantastic pathway of practical and emotional support?
Will it buggery.

LadyMaryChristmas Thu 27-Dec-12 19:38:43

That's what the old computer system was designed to do it was scrapped IIRC.

Sirzy Thu 27-Dec-12 19:38:47

Lady - when they are triaged at our local hopsital nothing like that is flagged up. They ASK the parents about it but that's it. Infact notes are stored off site so they have no history unless that patient is admitted.

The system as it is now doesn't work, there are to many variations of it and not enough communication between agencies.

anothercuppaplease Thu 27-Dec-12 19:39:24

It was scrapped because it was too 'bureaucratic'.

I don't think the 'processes' have been changed, ie send letter to GP, way of reporting suspected abuse. But the information platform or database was not helping solve the problem. For example, a A&E doctor would see a child with a broken arm, and maybe a few other bruises, and follows the procedures in place. But she/he cannot check as the treatment is administered, if the child already has a social worker, or has visited another A&E within the last months, or has had the other arm broken twice, or is living with parents who hae already been visited by social workers and are on the social care system.

The new database provides this information as the child is there, at A&E, or GP. Does that make sense? That's how I understand the news articles anyway.

yes, i thought it was scrapped,
so tis bollocks indeed,
the tories just trying to take credit,

LadyMaryChristmas Thu 27-Dec-12 19:41:12

I'm with MrsDeVere on this. Training is the key. The junior doctors don't get enough training to spot non accidental injuries. They are in each department for a very small amount of time and their hours are reduced thanks to the working time directive.

Sirzy Thu 27-Dec-12 19:43:50

I agree Mrs.

I think it would be great if this system highlighted child x has been admitted a lot/with something serious lets make contact to ensure all is well and further support isn't needed. I know that's supposed to happen now but it doesn't in my experience.

My 3 year old has been in A and E more times than I can remember and admitted about 15 times. I know the HV has been informed of these visits yet I have only been contacted by her once to ensure all was ok and that was after the least serious visit! I am lucky I have a supportive family but if not as a single mother with a poorly child I could have been struggling and nobody notice.

I think the database has the potential to help but only if properly implemented which I doubt will happen

LadyMaryChristmas Thu 27-Dec-12 19:43:54

They should never have scrapped the IT upgrade. Fools!

LadyMaryChristmas Thu 27-Dec-12 19:46:20

Sounds like that's an issue with your HV rather then the computer system, Sirzy. The one I worked with (briefly) spent the majority of her time dealing with families known to SS so other families don't get the time or attention that they need. There needs to be more HV's!

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