Information sharing in child protection matters: The development of the National Child Protection Alert System in New Zealand

Background Secondary care services in New Zealand are arranged into 20 autonomous District Health Boards (DHBs), with little ability for DHB information technology systems to share clinical information. Mortality reviews... [ view full abstract ]

Background
Secondary care services in New Zealand are arranged into 20 autonomous District Health Boards (DHBs), with little ability for DHB information technology systems to share clinical information. Mortality reviews frequently identify poor information sharing contributes to negative child protection outcomes.

Objective
The National Child Protection Alert System (NCPAS) was established in 2003 to share child protection information between DHBs. The electronic flag signals that health information exists in regard to child protection concerns for a child or young person on a DHB clinical record. To place an alert there must be a referral for statutory intervention and a multidisciplinary team must determine that future clinicians should be made aware of this health information so they can consider its relevance (or not) on future presentations.

Method
The alert system was piloted in one DHB in 2003 and scaled up gradually, resolving issues as they arose. All 20 DHBs will be using NCPAS in 2016, with nationally consistent processes and quality assurance, which will be described. Ethical issues, for example balancing parents’ rights to privacy and children’s right to safety, have been addressed and will be discussed.

Results
The NCPAS toolkit now includes a privacy impact assessment, policies, documentation forms, a training package and quality assurance processes. All DHBs are required to demonstrate that they have the required infrastructure before lodging alerts on the national system and to participate in regular re-certification. There are more than 15,000 alerts on the system, ensuring clinical staff have access to the information. The system has support at national policy and front-line sector level.

Conclusion
To make effective decisions in child protection, frontline clinicians must have access to the relevant information. The barriers to sharing information are common and complex; establishing a national infrastructure reduced barriers and enhanced consistency.