Information sharing in the safeguarding context: Home Office report

Report front coverThe final report of the Home Office research into “Multi Agency Working and Information Sharing” has been published this week.  The final report looks in more depth at the findings which were shared in the interim report, by validating the conclusions with two expert panels, and by conducting a questionnaire of practitioners working in multi agency safeguarding settings.  The report makes for interesting reading, and sets out a number of commitments that the department is making in order to continue to support multi agency working and information sharing.  One commitment that the report makes is that the Home Office will work with the Centre, to provide targeted support to Multi Agency Safeguarding Hubs, and to disseminate the learning from those.  We’ll share more details on that work as it progresses.

The report also clarifies the situation following the ‘Haringey judgement‘, where a judge ruled that the council’s data gathering had been unlawful because consent from the data subject was not sought.  The Home Office has reiterated that, although consent is one gateway to enable processing of sensitive personal data, there are alternatives, which include the requirement to share information to enable statutory functions – such as child protection – to be carried out.  This will hopefully provide reassurance to those who were concerned that the Haringey judgement could impede information sharing in safeguarding situations.

On to the findings… what is interesting about the report is that the advantages of developing a Multi Agency Safeguarding Hub come, not from its existence per se, but from the process of setting up and implementing one – developing a MASH provides the reason to work on these issues in a multi agency setting. The benefits of a MASH are listed as more accurate risk assessment, better management of cases, greater efficiency (with few step up / step down scenarios) and better understanding between professionals, so let’s take those one by one.

More accurate risk assessment

A more accurate risk assessment relies on understanding the risk thresholds of each agency involved in the MASH – this is particularly important where thresholds might be rising, in order to manage limited resources.  Then it’s a case of working out as a partnership where the thresholds should lie in the multi agency process, establishing what information is needed to make that risk assessment, and putting the processes in place to bring the right information together, present it in the right way and at the right time to the right people.

Better management of cases (with greater efficiency)

Again, this relies on working out how the statutory duty to safeguard children is going to be discharged i.e. who is going to make the decision about what course of action is appropriate, and who is going to lead activity.  And all of these benefits are underpinned by…

Better understanding between professionals

Now, this might come from co-location, which is highlighted in the report as being a helpful factor in having a successful MASH.  Or it might come from spending time together, undertaking multi agency training sessions, such as the EASI sessions developed by Dr Sue Richardson.  The Effective and Appropriate Sharing of Information workshops bring practitioners together around a scenario, exploring the motivators and constraints which affect different parts of public services, and give practitioners real insight into why their public sector colleagues might have different priorities when it comes to sharing information.  Having a shared risk assessment process, clear ownership of cases and insight into the work of others all helps to build better understanding and more effective multi agency work, which helps to break down the cultural barriers that exist between public sector agencies.

Those cultural barriers were noted in the report as being one of the biggest issues impeding better safeguarding activity, and they are (of course) the areas where the Centre of Excellence places its focus.  The other barriers noted within the research are also worth reflecting on.  The majority of MASH-type functions have been set up to support safeguarding activity – where there is extremely high risk to individuals, and where there is a clear legal framework for intervention.  But a number of respondents noted that a similar approach could potentially bring benefits to earlier intervention work; however, the legal framework is not as definitive.  This is a message we increasingly hear, and we will be exploring it further as we develop new case studies.  Indeed the MASH in Leicestershire and West Cheshire’s Early Support Access Team both support earlier intervention.

The other risks to successful multi agency safeguarding work were around being able to monitor performance, and to resource the MASH.  In many cases, better information sharing can lead to an increase in safeguarding cases as risks are understood, which has an impact on resource requirements – and also demonstrates why earlier intervention is so important.  This shows how perverse incentives may be at work, to make improved information sharing less attractive! And the complexity about demonstrating the impact of implementing a MASH (or in fact any information sharing) is one which has been noted here on many occasions.  Hopefully, we can start to consider this in more depth in the coming months, with the input from our expanded team, and the support of the Academic Advisory Panel.

Just can’t wait to get on the road again

Since we launched in April, we’ve been touring the country to exhibit and speak at a range of events and conferences. While our green and black colours have been getting some geographic exposure, our profile on Twitter has been growing and our website has received more and more visits by the month.

While we regroup to catch our collective breath and prepare for our wider team launch in the autumn, below is a brief round-up of where you might have seen us this summer.

Charlotte and Nicola speak to a visitorIn May we exhibited at the Public Sector Show at the ExCeL London. You can read more about this event in our previous blog post – Sharing information and transforming services at the Public Sector Show.

BsAjKbUCEAA-2vDIn June we took our new banner and postcards to exhibit at the LGComms Academy in Manchester. As well as raising the Centre’s profile with communications colleagues across the sector, it was inspiring to hear how they are delivering effective communications while still innovating, despite ongoing industry pressures and financial challenges.

BslAwVDCUAIqj2IEquipped with our trusty banners, postcards and all-important sweets, in July we joined colleagues from Public Service Transformation Network and PwC to exhibit at the Newcastle and London legs of Civil Service Live. At St James’ Park, home of Newcastle United Football Club, we pitched our stand under the watchful eyes of a Kevin Keegan photo to speak to civil servants from across the North East – a good mix of people including lots of front line staff who were eager to share some of the information sharing barriers they face. In London we were equally rushed off our feet – and we don’t think it was just down to the mints we gave away! We had the opportunity to speak to people from a range of government departments and hear about some innovative projects, such as London Connect, as well as doing a cheeky Civil Service Live pledge (see photo!).

Br9LZTaIIAAPJFIIn July we also squeezed in a trip to the Bournemouth seaside to exhibit at the LGA Annual Conference. Between sheltering from a seasonal hailstorm and indulging in fish and chips on the beach, we spent three days promoting our information sharing vision to council leaders, senior officers, and policy makers, and we also made some exciting connections with a number of voluntary and private organisations. Just 10 months away from the General Election, there was a distinct air of ‘making things happen’ and with the launch of the LGA’s ‘Investing in our nation’s future: the first 100 days of the next government’, our message for breaking down barriers and sharing information better was positively received, albeit with tentative apprehension that our task is a big one. We look forward to demonstrating that we’re up to the challenge!

Also in July…

Stephen Curtis delivered a well received session about debunking data myths and the reality of the information sharing vision to the Transforming Technology in Health & Social Care summit in London.

Charlotte Piper joined a dynamic panel at the Public Service Transformation Conference in London to explore how organisations can overcome the challenges surrounding sharing data to ensure they provide efficient, person-centered services.

In short, we’ve been on the road so much lately that we may be in the market for a roadie with a tour bus. That’s about it for now though until the autumn so while we are working hard behind the scenes to get our new team in place, enjoy the great British summer!

I fought the law, and the law won (until the Law Commission recommended a review)

As many readers will know, earlier this week the Law Commission released their report into Data Sharing between Public Bodies.  Those desperate to know the outcome will already have worked their way through the weighty tome, but I thought I’d highlight a few points for those who might be contemplating it as holiday reading!

Law Commission report front cover imageThere’s no such thing as a perfectly rational actor

The influence of behavioural psychology and insight has spread far and wide (see the Behavioural Insight team, amongst others) and it seems that the Law Commission has taken this on board.  The report acknowledges that the development of legislation doesn’t happen in a vacuum – external factors such as current public preoccupations, high profile individuals and political movements all have an impact.  Likewise, the way that legislation is applied is also affected by a variety of factors.  The Law Commission are clear that those external factors are outside its control – but that they have had on impact on the development of legislation related to information sharing over the years, and should be considered when contemplating future reform, as non-legislative activity might (will!) be needed to support any legal changes, whether that means codes of practice, training or case studies and practical examples.

The picture is complicated (and getting more so)

One striking conclusion of the report is that the legal landscape around information sharing is enormously complicated.  When a scoping project, conducted by a Law Commission team, works on the topic for around nine months and concludes that a list of relevant legal gateways is beyond its resources, you know how complicated it is!  At least now if anyone asks the Centre for a comprehensive list, we can point to the Law Commission’s conclusions on the impracticality of the task.  The proliferation of specific gateways also makes organisations less willing to rely on wider powers (such as the Localism Act).  An increase in commissioning and innovative service delivery means we need to think about sharing with third and private sector organisations.  And alongside the enormous number of gateways, the report makes the point that many gateways duplicate one another or cover very similar territory, making it difficult for organisations to know which gateway they should use in which scenario.  The variety in interpreting gateways is also noted – as the report says, that isn’t strictly a legal problem, but it does highlight that there might be a problem stemming from legislation.  Which leads me to…

There’s a lack of resource and expertise in this area

The report notes that specialist legal expertise around information sharing is in short supply, particularly outside the big government departments and agencies.  In fact, from our point of view, the key is to look at all the factors influencing information sharing, not simply legislation, so while legal eagles and information governance gurus are a key part of the team, they’re not the whole story.  Information sharing isn’t a job in itself – it is the responsibility of all of us involved in developing and delivering public policy, and so it is often poorly acknowledged and under-resourced.  Part of the Centre’s mission is to get information sharing recognised as a key enabler of delivering better public services, so that conversations about information sharing law happen in context.  And the report’s conclusion, that the legislation needs clarifying and simplifying, will hopefully make it easier for bodies to agree information sharing approaches, without getting trapped in legal argument.

There are no easy answers

Information sharing queries are often a search for the absolute.  A straightforward yes or no answer to the question “Can I do this?”.  But, more often than not, there isn’t a simple answer – it comes down to a balance of risks and benefits, being innovative while maintaining safeguards, and being willing to take decisions, supported by evidence.  The report follows that same theme: there is a balance to be struck around the public interest (respecting the privacy of the individual, whilst also making best use of limited public funds for the benefit of all), around the burden we place on the state against the burden on the individual (such as the use of consent), and around the need to be strategic and future-proof legislation, against the need to be specific in order to prevent abuses.  Policy and guidance over the last few years has demonstrated that thinking about information sharing does swing backwards and forwards, and that creates inevitable challenges for those creating and using legislation.  We can’t get away from those challenges, but it shows that an active balance needs to be maintained, rather than letting things slide too far one way or the other.

In conclusion, the Law Commission recommends a full law reform project, which (if accepted) will take two to three years to complete.  The Law Commission also recommends that “soft law” solutions (such as guidance, training and sharing best practice) should be considered within that.  So the work of the Centre is likely to be of great interest to a reform project, and we will certainly be ready to contribute in any way we can.  And in the meantime, we will do our best to help resolve some of these issues on the ground, and move the conversation about information sharing forward.

 

Sharing and caring: a case study on E-Health Insider

A new case study, published on E-Health Insider, looks back over the history of information sharing initiatives in the pursuit of more integrated health and social care, and asks what lessons can be learnt from what has happened so far (hat tip to the ever helpful James Freed at Public Health England for highlighting it).  The case study highlights that more integrated records (to improve patient experiences, and reduce inefficiency) have been a long term goal in the health service, but that changes in priorities and approach have led to a ‘patchwork’ of initiatives across the country.  Some of these initiatives are profiled in the case study, and there are a few key lessons and themes to come out of them all:

  • Pilots are all very well, but you need to reach critical mass

While we’ve seen evidence that starting small minimises the risk in innovative information sharing projects, there comes a time when the service needs to be embedded into normal service in order to be sustainable.  The case study’s authors say

This may be one reason that so many national and local projects have failed over the years; they never managed to cover enough people, include enough information, and get well enough embedded into local workflows to succeed.

For me, the key point is the last one.  So often information sharing becomes an ‘add on’, which could make a difference to the way professionals do their job – if only they would use the new service / approach / system!  We all need to be realistic about the likelihood of people using any approach which needs complicated additional security, logging out of one system and into another, or remembering to check a box that can normally be safely ignored.

  • Information sharing projects need time and commitment

Screenshot of Hampshire Health Record webpageThis is definitely borne out from the experiences we’ve seen – as the authors rightly say, information sharing can help deliver better, more joined-up services – but it isn’t a quick fix.  Anyone who has seen Stephen or I present on the Leicestershire Multi Agency Information Sharing Hub will remember the slide “Give it time” is closely followed by “Give it some more time”.

  • Sorting out information sharing agreements take time

Again, this echoes with what we know.  But here my experiences diverge from those of the authors.  The authors suggest developing

sample business cases, data sharing profiles, and model information sharing and consent agreements

Some of those things already exist here on the website, and more will be shared as we work with more areas on a broader range of topics.  But each area develops agreements or documentation which meets their specific needs – because often it isn’t the agreement that needs working on, but the relationship.  That takes time to develop – not just the paperwork.

  • There is surprisingly little evaluation of what works, and what it delivers

This is definitely something that rings true.  In fact, early ideas for how the Centre of Excellence might develop were modelled on the ‘What Works’ centres, with a focus on sharing evidence of the impact of information sharing.  We rapidly realised that the evidence is thin on the ground, so it is one of the key things we will be working on with local places: how can we demonstrate the impact that information sharing has had for them?  And how did they do it?  We look forward to sharing that evidence as it develops, but in the meantime, if you have evaluated the role of information sharing, why not get in touch, and help develop a case study of your own?