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

Mosman Fri 28-Dec-12 06:58:27

If I had been born now in 2012 I wouldn't be alive today.
A heart murmur was picked up at my 12 month check with the GP and I was found to have a hole in my heart which would have killed me before my 2nd birthday. I looked fine, no other symptoms.
My son aged 2.5 hasn't had a stethoscope on his chest ever.
I find that worrying, parents abusing their children will just not take them to a hospital any more once this becomes common knowledge.

LottieJenkins Fri 28-Dec-12 08:42:21

I had to take Wilf to three different casualties in six months once. On holiday with family he swallowed a ball bearing............ then he fell off a dinosaur on a day out in Norfolk and then swallowed a hearing aid battery a few weeks after that. The following summer he fell off a storage box in our garden and landed on concrete. If that all happened now (and he was the same ages as he was then) I would be worrying!

PiccadillyCervix Fri 28-Dec-12 09:57:37

Of course this is a good thing, it is ridiculous it hasn't been in play all along

larrygrylls Fri 28-Dec-12 10:14:24

I think it is a terrible idea. Abusers will avoid A&E all together and even normal parents will overthink whether A&E is necessary if they happen to have a run of accidents.

Frankly, I also doubt whether any NHS IT solution will ever be effective. My only experience was when our (then) 5 week old spent 4 days in hospital including 2 days in PICU on CPAP. 5 WEEKS later I got a call from the Health Visitor team who thought our child was still in hospital and asked what they could do to help. Erm, nothing as he was by then entirely healthy and, unless they had all the equipment and expertise of a teaching hospital, I am not sure what they could have done anyway. Complete waste of time.

If this were to be done at all, it should be done quietly so abusers are not deterred from taking their children to A&E. I would be curious to know how paediatricians feel about this. I would have thought they would prefer to make a judgment call themselves rather than have a computer system making impersonal referrals without sight of the child or parents.

SorrelForbes Fri 28-Dec-12 10:25:14

Attendances at A&E are already recorded on the hospital's A&E system. This data then feeds through to the Hospital's main patient administration system (PAS). The PAS also shows all hospital contacts (outpatient appointments, admissions etc.). The data is already there for HCPs to see. What needs to be added (or pulled through from LA systems and the Child Health information system) is data on contact with other agencies. This would give a fuller picture of the historical contacts and current status of involvement (if any).

Many Child Health information systems (software used to record HV checks, schedule vacs etc) already collates this data.

What isn't in place is the ability to see the same info from other hospitals/LA. Some areas are already working on CHI systems that cover more than one primary care trust. The CHI in Devon is one example of this.

FivesGoldNorks Fri 28-Dec-12 10:27:44

The local pct will hold data on a and e attendances at all trusts

ZebraInHiding Fri 28-Dec-12 10:58:55

Nice post choco.

I would have agreed with it had it not been for what happened when my ds was born at 28 weeks.

I was vilified by the hospital he was in. One consultant took it upon herself to admonish me for smoking while pregnant, thus making him ill, in front of a room full of nurses, parents and a SW (there on a visit to another parent who had sadly lost one of her twins). I don't smoke. Haven't done for 13 years. No interest in doing so again.

I was then told that ds could come home- was over the moon. Had to have a SW round to check we had room for oxygen tanks etc (we did). She mentioned my smoking while pregnant, the fact I'd apparently caused dd to have delayed speech and a burst eardrum due to using a dummy (never did- hate the bloody things, and have video of dd at that age (18 months) chatting quite happily and meeting milestones). This had come from notes made by a MW. I've since checked and she did not get this info from my GP, GP was confused as there was never any suggestion of wrong doing on our part, dd had an ear infection on and off for months which caused her ear drum to rupture.

Then came a call from the Lead Sister at SCBU- I couldn't take ds home as I'd only spent the equivalent if a week with him in the 4 months he'd been in SCBU. Utter bollocks. There was a lack of nursing staff who simply had too much to do so forgot to tick the box on my attendance on his notes. The same lack of staff meant ds' head had grown flat on one side and he constantly looked to his left (which we had to sort out at home with exercises as if we didn't have enough to do with oxygen tanks and meds etc).

Luckily, I had my bus tickets, the whole lot, as I'd found out I could claim some of the amount back (£8 per day) as we were on a very low income then (dp had to quit work as I was at the hospital day in day out so he looked after dd).

Until these kinds of mistakes (which I strongly believe contributed to my nervous breakdown) are wiped out, this sort of process is open to errors. I'd also be worried that, should a parent make a complaint against the kind of arsehole I dealt with, then the old vindictiveness would be used and you'd end up with ss knocking on your door. They drove us mad for a year due to the mistakes made above until I threatened to sue for harassment. The problem with SS is that they only have to have a suggestion of something wrong and they will pounce all over a family.

DoubleLifeIsALifeHalved Fri 28-Dec-12 12:03:43

Agree with all the posts saying that more data is not going to help... It's making connections that would save children's lives, & that takes well trained & specialized humans, not another computer system.

In any of the cases where mums have had a horrible time with ss the common thread is untrained people making their own opinions into 'facts', which get written down & as they are written turn into absolute facts by the next reader. Often ignoring the medical professional who really is qualified & knows 'the facts'.

How a database helps this I am not sure. Who exactly will be on charge of linking data (some of which will probably be untrue, entered wrongly etc), and who exactly is qualified to make a judgement? Hummm.

Our whole attitude to child protection stinks, & for some reason everyone feels its ok to have some innocent families go through hell because of it... As if a few 'casulties' of the system somehow prove the system is catching the cases where children are in danger... Very dangerous & faulty logic.

picketywick Fri 28-Dec-12 12:26:37

It may be largely a publicity stunt. Theres a lot og govt ones about

Couldn't agree more Double, especially when you then hear of appalling cases where the SS had lots of opportunities to step in and prevent abuse or even the death of a child.

Considering one of the major cock ups which caused my experience was due to over worked staff and understaffed wards, having yet another "box to tick" makes no sense at all. These health care professionals (and before anyone flames me, my dp is an ex-nurse and Dsil is a current nurse working at the same hospital where I had this poor experience) need to be able to do what's first and foremost of importance, which is caring for their patients, rather than adding in admin work to their job descriptions.

MrsJREwing Fri 28-Dec-12 12:27:05

Double, have you got a decent PA and have you got your housing sorted?

It mystifies me too, how anyone can justify the "system" abusing me and my children with as has been said crap opinions written by professionals with no medical training or knowledge of our health condition. Being bullied for the way our disability and their ignorance.

There is a culture of how dare someone wrongly accused complain like you have no rights to be upset at being treated like shit. Like they have no empathy for you and your children being abused by professionals, empathy apparently is limited to children abused by their family.

picketywick Fri 28-Dec-12 12:28:05

We are all on many data bases already. We will never be told how many. Orthe truth about who has access to our info.

FivesGoldNorks Fri 28-Dec-12 12:41:51

yes you are told and you are told why. AFAIK only criminality or CP issues can overrule that.

MrsJREwing so true. And the sad thing is, as so few people are willing to say "hey, this is not on, I will write and complain", there is a culture surrounding the few of us who do. I was told I was a "trouble maker" by a SW for asking my GP to remove the HV who caused the smoking/ear drum mistake- my GP firmly supported my decision, the SW saw it as a way of having a pop at me.

I made a massive, truly massive email complaint in August of last year as a result of feeling like ds had been left to us to do everything for, that the consultant had more interest in extracting gossip about us than actually taking an interest in his health (we are unmarried, which she chose to believe meant dp and I didn't live together, despite her being told repeatedly for 3 years she was wrong. She was sending hospital appointments to our old address thinking dp lived there). She constantly asked about "my mental health" when I challenged her lack of interest.

By the time ds had a massive asthma attack and went blue, resulting in ambulances etc, not to mention upset, purely as the medication we'd been given was inadequate, I'd had enough. GP again backed me and ordered a referral to another hospital team and told me I must complain.

It took until February this year to get a half hearted "fingers in ears" response that "lessons had been learned" and admin is so difficult to organise due to a lack of staff . But basically I was told it was all our fault and to sod off.

If they cannot handle the simplest of admin now, how on earth do these people expect a data base to achieve anything? These are tired, on occasions stroppy at the wrong person people who are overworked and under paid. There is a genuine cloud of malaise hanging over the NHS. A consultant who had ordered tests on me due to being concerned about fainting black outs I'd had was not surprised that these hadn't happened despite him asking 4 times for them- his answer was "well, that's what you get in the NHS, it wouldn't happen with private hospital staff".

That is what the Government needs to sort out, not this "jumping rather late on the Baby P band wagon to win votes" idea they have nicked from Labour.

woozlebear Fri 28-Dec-12 14:54:43

I was abused as a child, and this certainly wouldn't have helped me. My mum repeatedly wrote me sick notes to get me out of PE at primary school if the bruises on my legs were too bad that day. School never once questioned this - even though I was clearly not ill. I once rang the police. They came to the house. My mum charmed them, they didn't even talk to me without my parents in the room. They went away. Nothing was even written down. My mum who barely ever took me to the dentist, once took me - after a gap of several years -after she chipped my front tooth after hitting me in the face with a mug. Was the dentist remotely suspicious about this? No. I was abused for years but never had an A&E sort of injury. I suspect what failed me is the very common assumption that nice middle class parents don't abuse their nice little middle class children who go to nice private schools.

MrsJREwing Fri 28-Dec-12 15:03:26

So sorry you were put through that. I walked away from rubbish said about me by ex and cafcass years ago, same crap not understanding our condition. I should have complained then, it was the first dealings I had with "the system or ss" and I had been a parent for a decade then. I suppose I am a " trouble maker" now to people as I am complaining and using their laws and rules against them, pointing out their errors and law breaks, reporting them to their authority over them. More people should do this. I am however in a position that my children are old enough to ask for files, employ a solicitor etc if necessary, they have had enough too of these people fucking up theur lives, so they can bring it on as far as I am concerned, I and my kids are informed and I won't let someone away wirh this again. These people need to be stopped from abusing innocent adults and kids.

Huppopapa Fri 28-Dec-12 15:06:00

The Government (who I loathe with a passion btw) has not announced a new process. It is not requiring the gathering of any data that are not already collected. It is not proposing a new database. Absolutely nothing is new except that data will be stored in such a way that they are accessible to practitioners faced with children with difficult-to-explain injuries.

It was suggested above that doctors need more training to spot non-accidental injuries. If only that we're possible. A spiral fracture of the femur of an immobile child is probably abuse, but a clean tibia break on a 3yo boy? How do any of the contributors to this thread think a doctor can tell when an accident is genuine? Asking the parents can be useful but abusers are often cunning and agree a story before presenting. How they are dressed, how they speak, how angry or panicked they are are almost useless as diagnostic tools, in case any of you were thinking about those options but didn't want to say. Asking the child can be useful but there is a narrow window - which is different for every child - between a child learning to speak and being capable of being scared into concealing truth, if that is what their carers want. Sad, but true.

What else is there, then?

Why does a doctor take a medical history whenever you as an adult seeks a consultation? Because diagnosis requires it, and without diagnosis there can be no treatment. Adults complain if a doctor doesn't ask them enough questions because we all know how important it is.

It follows that if either of my DDs goes to A & E I want the hospital to have as much information as possible. Why wouldn't you want that too? The raw data which will be available if this database-sharing initiative works (big if!) will be part of the picture used to treat our children. The fact that a child has been to hospital many times proves nothing, but it can inform clinical observations just as knowing in an adult whether or not they smoke.

Those children with conditions requiring frequent medical attention will be better protected when every medic who encounters the child can see that by consulting the computer. Frankly I am HUUUGELY suspicious of anyone who claims their child has, say, brittle bones and would be greatly assisted to know immediately that they are telling the truth.

I don't understand the comments about 'box-ticking'. All this information is gathered anyway and is shared with varying success as observed above. What is proposed is not a process, or a step in treatment to be completed before the practitioner moves on: it is a means by which a child's medical history can be available to a practitioner when that child is in her or his care. To talk of 'box-ticking' is to misunderstand how emergency medicine works.

As for those who think that abusers will not take their children to hospital because they will get in trouble, consider that children keep turning up at hospital even when abuse is obvious. Even the most inadequate and (literally) hateful parents do not want to be prosecuted so - as unlikely as it may seem - come to hospital for the child to be fixed before s/he gets worse. Sadly, the parents want to save their own skins more than they care about their children so I can't see that process stopping.

Finally, a word to those who say they would be more reluctant to take their children to A & E because of this. Please have a long, long moment to think about that. You are actually saying that you would deny urgent medical treatment to your child because you are scared of what others might think about you. That is a stunning and disturbing admission which, frankly, I don't believe. If you think your child needs to go to A&E you take them immediately and hang what anyone might say. They are your joy, your own, your responsibility: they rely on you to be brave. If you pause, that is a cause for concern.

Best wishes, Huppopapa (who went to A&E as a child with an axe-wound!)

bruffin Fri 28-Dec-12 15:14:42

My dd hurt her hand pre victoria columbie and my HV knew about it within days, so not anythibg new. My dcs were born 95 and 97 and my ds had far more check ups than dd born 2 years later.

MrsDeVere Fri 28-Dec-12 15:24:09

I don't think this will stop people going to A&E.
Abused children do get taken to A&E even though the parents will be aware they will be questioned. The ones that don't get take now, won't get taken if there is a new database.
Lots of the parents live such chaotic lives they wouldn't have the first clue about tracking systems anyway.

Loving parents are not going to avoid A&E if their child is hurt. They will be anxious but lets face it most of us get a bit anxious already.

IF this works it will be a good thing. But it will not work in isolation. Unfortunately the only way to keep an eye on children involves collecting sensitive information.

There is no other way. Collating and sharing information is a vital part of protecting children. Staff need to be better trained.
What info to record
How to record it e.g. factual and no assumptions
Data protection - I am frequently pissed off by people gabbing about things they should keep to themselves.
Not assuming that someone else has picked up on something. A call, an email to check can save a child.

Mosman Fri 28-Dec-12 15:29:02

I'm amazed abusers take their children to a and e, I'm even more amazed they are allowed to take them home and do it again.

Spero Fri 28-Dec-12 15:38:19

Just read a ridiculous article by Simon Heffer in the Mail where he says that he would not take a child to A and E after his wife was questioned when she took in their toddler son who had a fractured skull. Even his GP - gasp! - was questioned about his view of the family. Their son went home and made a full recovery.

I have no problem whatsoever with hard questions being asked when a child presents with serious injury. What is the alternative? Sending child home to be killed later on?

If this is the attitude of presumably intelligent and well educated people, then we really are doomed. We need a shift in attitude; protecting children is the business of us all. Can't see how a database is going to be a magic wand, as so many have said, it is how information is analysed and shared that makes the difference.

Spero Fri 28-Dec-12 15:40:49

And re abusers not going to a and e, a surprisingly large number of children are taken to hospital either dead or dying, by the same people who attacked them. I agree completely with Mrs Devere - most child abusers are not very good at forward planning, most child abuse comes out of chaos and misery, not calculated evil.

MrsDeVere Fri 28-Dec-12 15:41:32

They take them because abuse is not simple.
They strike out, they hit they burn, they leave a sick child without treatment.
Then they panic and think they better take the kid to hospital.
Then they lie about what happened. They are manipulative.
There is no proof its an non accidental injury so they take them home.

Which is why a good data collection system would help. AND robust training for staff. Doctors can be in their early twenties with a couple of weeks experience of A&E medicine and NO paedatric experience. They are faced with an accomplished liar with a lot to lose.

No wonder kids slip through the net.

Sirzy Fri 28-Dec-12 15:43:03

Mosman - unfortunately its not always going to be possible to identify that their is a problem though. This is where this system could help as if a child is on the at risk register it would be automatically highlighted and therefore sound the alarm bells. The important part though is how that is dealt with.

When I take DS to A and E i am asked "do you have a social worker" - the onus is on the parent to tell the truth rather than having a set way to immediately check this out.

If the system is going to show they have a SW I hope that some sort of coding will be included to give an idea of why - it could simply be a child with disabilities so the SW is providing extra support or it could be an at risk child.

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