Child Abuse and Neglect, Vol. 3, pp. 175 - 177. 0 Pergamon Press Ltd., 1979. Printed in Great Britain.

0145-2134/79/0301-0175 $02.00/O.

STUDY OF CENTRAL CHILD ABUSE REGISTERS IN ENGLAND AND WALES 1977

Mrs. Jane Jenkins

South Glamorgan Social Services Department Cardiff.

1978

INTRODUCTION

A Department of Health and Social Security memorandum (1) circulated to all Local Authorities in 1974 recommended the setting up of registers of all known cases of Child Abuse :-

" A central record of information in each area is essential to good communication between the many disciplines involved in the management of these cases".

Child Abuse Registers were intended to be one element of a comprehensive system of a multi- disciplinary approach to the effective management of cases of Child Abuse. As little detailed guidance was available to those responsible for setting up these registers, it became clear that there was not standardization of approach throughout the country and concern was expressed as to their general effectiveness both locally and nationally.

The object of this study is to examine the extent of these variations in register manage- ment throughout England and Wales and to a assess the efectiveness of registers for the purpose for which they were originally intended.

METHOD

115 comprehensive questionnaires were sent to Local Authorities in England and Wales in January 1977. Topics covered included the size of registers; criteria for inclusion; the times at which the registers were made available and to whom; confidentiality and general safety precautions; reviewing and de-registration procedures; the range of informat- ion contained on a register and the extent to which the register was used.

102 completed questionnaires were returned and 100 were selected as being suitable for analysis.

FINDINGS

Analysis revealed a considerable variation in the way in which registers were designed and subsequently maintained.

The number of cases on any one register varied from 5 to over 1000 cases. Whilst this is partially related to the population of each area which the register covers, it is also influenced, more significantly, to the strioking variation in the criteria for inclusion. (See Table 1)

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176 J. Jenkins

TABLE I

N.A.I. Overt and Suspected N-A-1. Cvert md Suspected; Potential N.A.I. N.A.I. Overt and Suspected;Clearcut Neglect 11 N.A.I. Overt and Suspected; Potential N.A.I.; Clearcut Neglect 3 N.A.I. Overt snd Suspected; Potential N.A.I.; Clearcut Neglect

and Potential Neglect 28 No response to this question 6

TOTAL 100

Only 1396 Authorities restricted inclusion to only clearcut cases.

4296 Authorities indicated that they also included cases of neglect on their register. A few also included "emotional" battering, moral danger and ingestion of toxic materiel.

6996 Authorities stated that they included potential or 'at risk' cases but it was also very clear that this category is defined in a variety of ways. For example, where a register is administered by the N.S.P.C.C. special units, very few potential cases are included, whereas in my own Authority of South Glamorgan two-thirdo of registered cases are classified as potential.

In 4496 Authorities the register was only made available for checking information during office hours.

Just over half the Authorities indicated that they only had one copy of the register. 4496 had at least one duplicate copy; this was often necessary in order to provide twenty-four hour cover, in that the duplicate copy would be lodged in a place where there was full time cover already, such as a hospital casualty department or a residential children's home. The administrative task of maintaining up-to-date information on the register increases with each duplicate copy.

Another very stricking variation of approach is related to access to the registers. To sum this up, 4% Authorities allowed only very limited access and 4996 indicated that they adopted a definite policy of allowing access to all agencies who might find the information useful. In this latter group however the wider access was frequently only via senior members of staff. The remaining 9% had no clear access policy.

Information contained on the registers varied from a few identifying items only to a very comprehensive and detailed list of all aspects of the child6 socialand medical background; more than 50 different items of information were recorded. This finding, I nuggemt, indicates the varying attitudes as to the purpose of the register and also poees important questions about confidentiality and therefore access policy.

9596 Authorities stated that the "phone back" system was employed for checking the authenticity of telephone enquiries. This seemed to be the most popular means of safe- guarding the register, but several Authorities also said that the register was kept locked and specifically stated that only limited information was recorded in order to cut down the possibility of breaches of confidentiality. This policy may conflict with the usefulness of a register in that the availability of very limited detail8 of the case only, may not provide the enquirer with sufficient information on which to base a decision about approp riate action.

596 of Authorities stated that they did not undertake any reviewing of registered case8. The remaining 9596 employed a great variety of methods which ranged from reconvening the original case conference to an informal discussion between key workers.

Reviewing procedures can broadly be divided into two types :- firstly, Active Reviewing -

i.e. reviewing initiated centrally by the register administrator, usually by means of a simple questionnaire tobe completed by the key workers of the various agencies involved,

Central Registers in England and Wales 177

and independently assessed. Secondly, Passive Reviewing, which is left to the discretion of the srea or district offices. The findings of this study indicate that 38% Authorities employ some form of 'active' xeviewing or monitoring procedure, and 5% had adopted the 'passive' approach which I suggest is probably less efficient and comprehensive. The remaining 5% did not give enough information about reviewing procedures.

Table II shows graphically the great variation in the frequency with which reviews are carried out.

TABLE XI

Frequency of Reviewing of Cases on a Register -Maximum time interval

According to Need Monthly J Monthly 6 Monthly Annually Less Requently Inadequate information or no reviewing

13

3; 34 J

:

TOTAL 100

12% Authorities had no procedure for removing a name from the register. Procedures for 'off-listing* once again varied a great deal although in nearly all Authorities the decision was a multi-disciplinary one. At least 1% Authorities maintain off-listed cases in a dormant or inactive list and de not destroy records.

One of the most &ricking findings of this study was the discovery that 65% Authorities claimed that their register was rarely used, especially by agencies outside Social Services, Only 2396 Authorities said that their register was regularly used - this included most of the registers administered by the N.S.P.C.C. special units where a tradition of register use seema to exist. The remaining 1% claimed moderate usage. Many Authorities clearly implied a degree of disappointment at how little their register was being used.

DISCUSSION

Rxamination of the findings in closer detail did not reveal any clear solution to ths problem of limited usage except that, as might be expected, those registers which were available on a 24 hour basis, were used significantly more. Broad access policy did not appear to lead to greater usage neither did the existance of duplicate copies. The larger registers, which favoured a broader definition of Child Abuse and Petential Child Abuse, were not used to any greater extent than those which included only clearcut cases.

These findings, I suggest, may lead one to question the validity of the very existance of the Child Abuse Register. Do they serve any really useful purpose? Are checks for identification purposes really necessary? Are registers ethically acceptable? Do they undermine professionaly autonomy, discretion and judgement? It is not in the scope of this study to look at these questions in detail but I do believe that the principal of the Child Abuse Register is valid if it serves to prevent even a few tragedies. I believe this study shows, however, that the lack of standardisation in approach to their administration makes it a less useful tool than it could be. l$ey should provide a central focus for thorough inter-disciplinary monitoring and ongoing assessment of identified cases of child abuse and, I believe, potential cases of child abuse. In order to do this there must be nationally understood criteria for inclusion and reviewing and de-registration procedures, They must be efficiently administered by specifically nominated personnel. Once a universal approach is adopted, not only could they become vital in ensuring more efficient management of Child Abuse cases at a local level but also provide a very valuable source of reliable statistical data on a national level in order that our understanding of the full extent of the problem will increase and a moxe accurate idea of resource allocation can be achieved.

Reference (1) D.H.S.S. Memorandum April 1974 (~SSL(74)13/~0(74)8).