Great leap backward?

Concerns over data-sharing, working across boundaries,
information technology and the stigmatisation of children are all
troubling professionals charged with implementing plans to
identify, refer and track troubled young people. Mark Hunter
reports.

When the government first announced funding for schemes that
identify, refer and track (IRT) vulnerable children, local
authorities were told to have their IRT systems up and running by
September 2003.

With that deadline now less than three months away it is clear
that the timetable has slipped somewhat. Guidance culled from the
experience of 10 trailblazing authorities was due out in March but
has been postponed pending the government’s Children at Risk
Green Paper, and the Children and Young People’s Unit is now
talking about a September deadline for the trailblazers, while the
rest follow on next March.

Given the Herculean scale of the task (and the meagre
£100,000 they have each been given to carry it out), it is
perhaps understandable that local authorities are taking their
time. If they are to fulfil the government’s intention to
have IRT procedures in place for every child at risk of social
exclusion they will not only have to create a common database that
can be used by a myriad of different services, but also to address
the cultural, ethical and legal questions that hang over the
sharing of often highly sensitive information.

For instance, will agencies as diverse as youth offending teams,
social services, the health service and the education system ever
trust each other enough to share the kind of information necessary
to make the system work? Who should be able to access what data and
under what circumstances? And is it possible to run an IRT scheme
without infringing young people’s rights under the Data
Protection Act 1998?

Peter Chester has been wrestling with these issues since April
when he took up the post of IRT service manager for Leicester,
Leicestershire and Rutland’s scheme, one of the trailblazers.
He emphasises that creating the common database is only part of the
job. “IRT is not just a technical exercise,” he says. “We see it as
an effort to improve the services that already exist by
co-ordinating them into a united whole.”

This will involve creating a shared assessment framework to
ensure that when a child is seen by services such as Connexions,
Sure Start, social services or the local education authority, the
data is collected in a universal format. “We are also looking at
the current referral procedures and finding out what are the
commonalities,” says Chester. Single referral forms will then be
produced to safeguard the flow of information when a child is
referred from one service to another.

In East and West Sussex, another of the trailblazers, protocols
are being put in place to determine what can and can’t be
done with the information once it has been added to the
database.

“What we are trying to do is create clear rules for the sharing
of information,” says co-ordinator of children’s services and
strategic planning Alison Jeffery.

“There are occasions when [sensitive] information should be
shared – if there is a risk of a crime being committed or a risk of
significant harm to the child – but there have to be very clear
rules about what those situations are and who has access to what
information,” she says.

How to protect the data once it has been collected requires some
strict security to be built into the system software. For instance,
Telford and Wrekin won its trailblazer status on the back of its
Aware electronic information system which uses thumbprint
recognition to ensure that only those with the correct authority
are granted access to the information.

This kind of data protection is essential if front-line
professionals are to retain the trust of the young people they deal
with, stresses Jeffery. If young people do not trust IRT then they
may be reluctant to divulge personal details.

“We have been consulting young people and getting expressions of
concern that something they tell one agency might be flagged up on
the core database for others to see,” she says. “The issue of
consent is also very delicate and there are a lot of data
protection concerns. In Sussex, children over 12 will be asked for
their consent on whether the information can be shared.”

Once the system is up and running, Jeffery hopes that vital
information will be made available across the range of services
that deal with children.

For instance, if a child enters accident and emergency with a
possible self-inflicted injury, the doctor will be able to use the
IRT system to summon the child’s past service history,
complete with the social worker’s contact details.

“It should be a quick and simple way of putting different
professionals in touch with each other,” says Jeffery.

For this to happen effectively, however, it will require more
than just better access to information. It will be necessary to
remove the service culture barriers that seem to prevent staff
within one agency communicating with those in another.

“IRT is not just a new system, it’s a cultural change and
there is an expectation that we will not just work within the
boundaries of our own service, but that we will talk to other
people,” says Jeffery. “Luckily, a lot of people are already
working within that culture. Youth offending teams, for instance,
are multi-agency teams who are well used to this sort of thing.”
Youth offending teams are also likely to be major beneficiaries of
the IRT programme. In fact, with 25 per cent of the
Children’s Fund budget now earmarked for partnerships with
YOTs, it has been suggested that IRT (also funded by the
Children’s Fund) may have been hijacked by the youth crime
lobby.

Crime reduction charity Nacro certainly seems to be reserving
its judgement on IRT. “It would be churlish to criticise early
intervention out of hand,” says a spokesperson. “But the success of
the prevention strategies will rest on exactly how such
interventions are framed. Providing mechanisms of support and
guidance to families in difficulty is one thing, but quasi-punitive
measures that serve to label and stigmatise children as young as
five are quite another.”

Other young people’s groups also have their concerns about
how IRT might be implemented.

“We welcome the principle behind the scheme but do have concerns
about how to get the balance between identification and
stigmatising a young person,” says Paul Ennals, chief executive of
the National Children’s Bureau.

“It’s a bit like the pre-crime panels. If it means getting
services to that young person quicker then that’s great. But
there’s always the danger of stigmatisation. Then there is
also the issue of confidentiality. It’s most important that
the views of children and their families are taken into account
when these schemes are being set up.”

For Gavin Baylis, senior policy officer at children’s
mental health charity Young Minds, concerns about the ultimate
objectives of IRT are hardly relieved by the programme’s
title.

“I’m not sure I like the term ‘tracking’,” he
says. “It would be nice if this was being done for the benefit of
the young people rather than as some sort of protection for
society.”

However, terminology aside, Baylis does support the principle
behind the IRT.

“The basic idea is sound. Undoubtedly, there is a significant
problem of co-ordination between agencies which can create
conflicting strategies. Young people can end up seeing 12 different
professionals in meetings they don’t want to go to. So if IRT
is able to address that problem then that has to be for the
good.”

Once IRT systems are in place, Baylis believes the next step is
to ensure that the information collected is used to its full
potential.

“For example, we need to be able to use what we know about risk
factors. The risk factors for mental illness and other markers of
social exclusion are very similar – things like violence in the
home and substance abuse. And if a child has four or five risk
factors then they are 20 per cent more likely to suffer mental
illness.”

IRT could therefore be used to identify children at risk of
mental illness and ensure they receive appropriate help, says
Baylis. “But that requires front-line professionals to have enough
awareness about risk factors. So there may be a need for extra
training.”

There is also the issue of who to refer the children on to. If
IRT results in a significant rise in the number of children
referred to children’s mental health

services, will the already overstretched service be able to
cope? For however effective the new IRT procedures are in
encouraging joint working and improving access to vital
information, the system cannot influence the way that information
is used.

So, while much has been made of the high-tech computer wizardry
necessary to allow multi-agency access to highly sensitive and
secure data, IRT will not ultimately be judged on its sexy software
nor its joint working procedures. It will be judged on how
effectively it helps vulnerable children.

Who is a vulnerable child?

There is no clear definition of a child who is at risk of social
exclusion. According to the Children and Young People’s Unit,
risk factors such as socio-economic disadvantage, neighbourhood
violence and crime, drug abuse, poor educational attainment, being
a member of a minority group and being a lone parent or teenage
mother can affect almost any child. Children may also move in and
out of risk according to changing circumstances.

Out of a total population in England of 12 million the number of
children facing particular risks include:

  • 2.7 million living in low income families.
  • Up to 75,000 missing from school rolls.
  • Around 10 per cent of children aged five to 15 who have a
    mental disorder of sufficient severity to cause them distress or
    have a considerable effect on the way they live.
  • The one in nine children who run away from home for at least
    one night.
  • Children living in the one in 10 families in England and Wales
    who report incidences of domestic violence each year.
  • Over 90,000 girls under 20 who become pregnant each year.
  • 5,400 households with children in bed and breakfast
    accommodation.
  • Approximately 300,000 children with disabilities in England.
    Some 110,000 of these are severely disabled.
  • More than 26,000 children and young people on the child
    protection register.
  • More than 58,000 children and young people are in public
    care.
  • 11,000 young people aged 15-20 are in young offender
    institutions.

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