Jovian Smalley, Engagement Manager
Centre of Excellence for Information Sharing
On a cold, dark night, a young man is seen standing at the top of a railway bridge following an argument. He appears angry, and in some distress. But is he violent? Is he drunk? If you are the police and responding to a call-out to handle the situation, what’s your best course of action, given such limited information? How is this story going to end?
When the risks to your own organisation are high and information scarce, making the wrong decision can be costly. This could be financially in terms of the services provided but also to the reputation of those services and that’s to say nothing of the cost to the health and well-being of the person at the centre of the story, and their family.
I recently attended a conference on Multi-Agency Information Sharing in London, in order to understand how working together and sharing information between agencies can transform our response crises like this. The conference was chaired by the Centre’s Director, Stephen Curtis, and was an opportunity to meet with colleagues from many of the places we are currently engaged with, including Havering, Dorset, South Devon and Torbay, and Sandwell & Dudley.
It was also a chance to hear from a range of other professionals sharing their expertise on data sharing and collaborative working, from the Information Commissioner’s Office and a legal attorney to an advisor on cloud computing and designated safeguarding nurses from Clinical Commissioning Groups in London.
Stephen began the day reflecting on this man’s plight. In times of tough financial choices and dented public confidence in public services, this story reinforced the importance of strengthening our multi agency arrangements and putting service users’ outcomes at the heart of these arrangements. I found three common themes woven through the day’s rich and varied discussions.
First, multi-agency working means leading bravely. Debbie Ward, Dorset’s Chief Executive put it very succinctly when she said “I’d rather take a bullet for sharing too much than standing by whilst information doesn’t get shared that puts people in harm”. And people in the room commented on how important it was to hear that message right from the top. For Carol Singleton, Sandwell’s MASH manager, strong leadership didn’t mean the Multi-Agency Safeguarding Hub (MASH) becoming a “Children’s Social Care roadshow”.
Instead, Sandwell’s vision was built on all twelve agencies in its multi-agency partnership having an equal say in the decision making process, underpinned by a system-wide culture of openness and transparency. Carol stressed the critical importance of being able to challenge opinions & decisions to gain the trust of agencies working in the MASH. She said this approach was encapsulated in one young person’s feedback calling the MASH “a call centre as a community”.
Next, multi-agency working means understanding risk. Debbie explained that her organisation was focused on this issue as part of their plans to launch a new Information Sharing Charter for Dorset . Previous attempts to strengthen their multi-agency arrangements had foundered because decision-making was passed up, creating a risk adverse working environment. For Pippa Brent-Isherwood, Head of Business and Performance at the London Borough of Havering, and Mark Clark, a Metropolitan Detective Inspector overseeing development of London MASHs, it was really important that risk assessments were carried out jointly based on decisions made on all the info available, and the mental capacity of adults to manage their own risks was taken into consideration.
Designated Safeguarding Nurses Anna Jones & Pauline Fletcher cited a risk adverse organisational culture as one of the biggest barriers to health agencies safeguarding children. Risk assessments need to be centred on the needs of service users and not become a bureaucratic blocker to information sharing.
Finally, multi-agency working means being inclusive: Vickki Cochran, Information Sharing Lead from South Devon and Torbay Clinical Commissioning Group, argued that by being inclusive and getting everybody to discuss the need to work collaboratively, they could encourage GPs to see beyond the risk of large fines, and get vital support from the Local Medical Council for the changes the partnership wanted to make.
After this, it was easy to get new partners on board, because everyone was able to see the bigger picture, and trust and confidence had been built into the system. This is a point Jonathan Bamford concluded in his keynote address: “information sharing can be vital, legal compliance is essential, inspiring public trust and confidence is indispensable.”
The young man whose story I opened with had previously received support from mental health services so, following a request for assistance from the responding officers, their new triage car attended the scene. These officers needed brave leadership, a shared understanding of risk and an inclusive working culture to be driving the triage car that night. After completing a joint assessment, the man accepted advice and support from the triage team and he was referred as an outpatient.
That scene would have ended quite differently had it not been for Leicestershire Police and the Leicestershire Partnership NHS Trust working together as one team, and sharing crucial information about the man’s mental health history.
Put simply, this story shows us that information sharing is everybody’s business.