Information Sharing forMASH Members

Housekeeping

• Introductions• Fire Exits• Toilets• Breaks• Phones• Learning Contract• Handouts

Aims of the Session

• To appreciate importance of information sharing

• To be aware of key principles and legislation

• To explore practice issues across professional boundaries

• Know the key sources of further information and support on information sharing

National Drivers

• Every Child Matters

• Children Act 2004, Sections 10,11,12

• HM Govt Information Sharing Guidance 2008

• Learning from Serious Case Reviews

• Development of safeguarding adults framework

• Munro

• Effectiveness of early help

What practitioners need to know

• How to share information confidently as part of preventative services, as well as where there are concerns about significant harm

• How the law applies to information sharing

• How to handle confidential information

• Who can give or refuse consent

• How to make decisions when unsure

• What information to share and how to share it

• What support they can access from employers

Local action

• LAs and their partners must ensure that information sharing is properly addressed including:

• Information sharing governance frameworks that focus on improving practice in information sharing (MASH ISA)

• Secure mechanisms for sharing information, within and across service and professional boundaries.

• Relevant managers and practitioners are trained and understand the legal basis for sharing information.

• Sharing information becomes an integral part of the way in which practitioners fulfil their duties

The framework for sharing information

Seven Golden Rules

1. Remember that the Data Protection Act is not a barrier to sharing information

2. Be open and honest3. Seek advice4. Share with consent where appropriate5. Consider safety and wellbeing6. Necessary ,proportionate, relevant,

accurate, timely and secure7. Keep a record

Key Questions Is there a legitimate purpose to share the information?

Is it confidential?

Is there a statutory duty or court order to share?

Have you properly recorded your decision?

Is there sufficient public interest to share?

If you share, is it the right information in the right way?

Do you have consent to share?

Does the information enable a person to be identified?

Confidential Information

• Evidence that the child is suffering or at risk of suffering significant harm

• Reasonable cause to believe the child may be suffering or at risk of suffering significant harm

• To prevent significant harm to children or serious harm to adults

Confidential information is..

sensitive, not already in public domain, shared in confidence

authorised by the person who provided it or to whom it relates

Can be shared unauthorised if justified in the public interest..

Can be shared if..

Practitioners must weigh up their decision – whether it is to share or not - and record the reasons for it

The Data Protection Act

1998

The Human Rights Act

1998

The common law duty of

confidentiality

Legislation containing express powers or which imply powers to share:

• Local Government Act 2000• The Children Act 2004 and 1989• Education Act 2002 and 1996• Learning and Skills Act 2000• Education (SEN) Regulations 2001• Leaving Care Act 2000• Protection of Children Act 1999• Immigration and Asylum Act 1999• Crime and Disorder Act 1998• National health Service Act 1977 & 2006• The Health and Social Care Act 2003• Mental Capacity Act 2005• Criminal Justice Act 2003 • Adoption & Children Act 2002• The Localism Act 2011• Welfare Reform Act 2012

The Law

The Human Rights Act

• Obligation to safeguard rights of children

• Article 2 Right to life• Article 3 Not to be

subjected to degrading treatment

• Article 5 Liberty and security

• Article 8 , right to privacy • But 8.2 , can be justified in

interests of• National security• Public safety• Economic well being of

country• Prevention of crime and

disorder• Protection of health, rights

and freedoms

Common Law Duty of Confidentiality

Not absolute

• If information not confidential

• If person has given consent

• Overriding public interest

• Court order/other legal obligation

The Data Protection Act 1998

Can person be identified?

Schedule 2• Consent• Protect vital interests• Court order/legal duty• Statutory function• Public function in public interest • Necessary for data controller

The Data Protection Act 1998

Sensitive information?

Schedule 3• Consent• Protect vital interests• Exercise legal rights/proceedings• Perform statutory function• Substantial public interests and necessary to

prevent/detect crime• Necessary for medical purposes

The Haringey Judgement

• Relates to an incident that pre-dates the establishment of a MASH

• Reiterates the importance of adhering to published information sharing guidance

• Reiterates the necessity of documenting all decisions about why we are seeking and sharing information and whether this is done with or without consent

• Does NOT say that information can only be shared without seeking consent when the threshold for a Section 47 is reached

Group Exercise

Information Sharing

Exercise 1

Sharing Information as part of Preventative Services

Increased emphasis on integrated working across children’s services to better identify and meet needs

Effective partnership working and information sharing between universal services and targeted and specialist services

Active processes for identifying children and young people at risk of poor outcomes (using the CAF where appropriate), and passing information to those delivering targeted support

Success depends upon…

Practitioners must:Openly and honestly explain information sharing Seek consent

Sharing information where there are concerns about significant harm

Practitioners must:

• Always place child’s interests first

• Always consider referral if concerns

• Seek advice if unsure

Sharing information where there are concerns about significant harm

Issues to consider:

• Significant harm can arise from varying circumstances

• Serious harm to adults

• Public interest

• Consent where possible

Group Exercise

To share or not to share?

Exercise 2Case Scenarios

Consent

• Must be informed• Can be explicit or implicit• Must be openly secured • Should be reviewed • Can be withdrawn

Consent

Practitioners must:

• Use clear language• Explain limits of confidentiality• Be aware of legislation• Follow procedures

Be aware of exceptions

Who can give or Refuse Consent?

• Parent with parental responsibility • Local Authority if shared PR• Court order• Age 16 plus or under 16 if capacity • Assessment of Fraser Competence

( generally 12 and over ) • Assessment of Mental Capacity for

specific decision (MCA 2005)

Assessing capacity for consent

• Points to consider when assessing a person’s capacity to make a specific decision at a specific time

• Does the person:– understand the question being asked of them– have a reasonable understanding of:

• what information might be shared• reasons for sharing the information• implications of sharing/not sharing the information

– appreciate and consider alternative courses of action– weigh up one aspect of the situation against another– express a clear personal view on the matter– keep a reasonable consistency in their views

What to share and how to share it Practitioners should:

• Share information necessary• Share with those who need to know• Ensure information accurate/up to date• Share it securely• Check understanding of recipient re limits of consent• Inform subject, if safe to do so• Record reasons for deciding to share

Recording: a Reminder

• Accuracy

• Time bounded/dated

• Fact or opinion?

• Sources of Information

• Validity of information

• What is the significance of the information

• Dynamic risk assessment

Recording : Good Practice for Information Sharing Requests • ‘How to Guide’• Record any requests received• Date and Time• Summary of information• Requestor details• Decision and reason • Consultation/Management endorsement where

necessary• Consent?• What is shared, how and with whom?

Sources of advice and support

• Your Manager or Designated Safeguarding Lead

• Caldicott Guardian

• Regular Training through your local LSCB or Workforce Development Team

• MASH Lead

Caldicott Principles (1)

1. Justify the purpose for using confidential information

2. Only use it when absolutely necessary

3. Use the minimum required

4. Access should be on a strict need-to-know basis

5. Everyone must understand their responsibilities

6. Everyone must understand and comply with the law

7. The duty to share information can be as important as the duty to protect patient confidentiality

Caldicott Guardian – Role (1)

Agreeing and reviewing policies

Ensuring the organisation satisfies the highest practical confidentiality standards

Acting as the ‘conscience’ of the organisation

Advising on lawful and ethical processing of information

Resolving local issues

Ensuring a record of resolved issues is kept

Caldicott Guardian – Role (2)

Representing and championing IG requirements and reporting issues at Board/Senior Management Team level

Working as part of a broader Information Governance function

(NHS Connecting for Health - key role in developing/maintaining NHS IT infrastructure)

A signatory for high level agreements

Useful Contacts / References

• Information Sharing: Guidance for practitioners and managers 2008 http://webarchive.nationalarchives.gov.uk/20130401151715/https://www.education.gov.uk/publications/eOrderingDownload/00807-2008BKT-EN-March09.pdf

• London MASH Information Sharing Guidance 2013 http://www.londonscb.gov.uk/mash/

• The Caldicott Guardian Manual 2006 www.connectingforhealth.nhs.uk/infogov/resources/new_guidance

Useful Contacts / References

• The Data Protection Act 1998 www.opsi.gov.uk/acts/acts1998/19980029.htm

• The Information Commissioner: for guidance on data protection www.ico.gov.uk/

• The Freedom of Information Act 2000 www.opsi.gov.uk/acts/acts2000/20000036.htm

• The Department for Constitutional Affairs: for guidance onfreedom of information www.foi.gov.uk/