Opinion

Information-sharing lessons from the
Victoria Climbié case

Five years ago, the Laming enquiry into the Victoria Climbié case found that despite investigations by local council services, the NSPCC, the police and the NHS into concerns raised by medical staff, there was a failure of communication between the relevant bodies to fully monitor and address the situation.

As we in the UK know, this had tragic consequences. Nine year old Victoria Climbié died in February 2000. Her carers were convicted of her murder following a campaign of sustained abuse — which, although reported by medical and council staff on several occasions, went unchecked. The Laming report found that the agencies involved in her care had failed to protect her and that on twelve occasions workers could have prevented her death [1].

The question is, to what extent were Victoria’s care professionals let down by a lack of access to critical information? The fact that hospital staff did not have visibility of a single 360 degree patient record meant they were at pains to determine the risk factors in the case. If they had access to such information, they may well have been able to see patterns of abuse emerging, and better helped to protect Victoria.

The importance of interoperability

The key to better 360 degree patient care lies in an integrated, interoperable IT system. The challenge is in joining up critical systems right across the healthcare landscape. Currently, data records in hospitals and healthcare units across the UK are fragmented, and old systems incapable of delivering 360 visibility of a patient's care are widely used.

Another problem lies with organisations themselves, as too often systems are deployed only at a departmental level, which means, for example, that a maternity system and an A&E system can exist within the same hospital without the two systems being linked. If a patient is admitted into A&E and then sent to the maternity ward, the patient is tracked through two separate records instead of one.

The government’s plan to link all patient records in the UK through the Spine has the potential to solve these issues and empower a patient to access their record no matter where they are in the UK. If a holidaymaker in Cornwall were to fall ill, under the new system they would be free to walk into a hospital, safe in the knowledge that their previous health history will be taken into account. Moreover, in cases such as Victoria's, patterns of abuse would be easier to identify and address.

While the national programme has been criticised for years, the recent HM Revenue & Customs and DVLA data loss cases have raised questions over whether government bodies should be trusted with sensitive information. In our experience, integrating large volumes of records across a population region can work. At Cambio, we have seen it first hand.

Cambio’s experience comes from deploying COSMIC, an IT platform designed specifically for the healthcare sector, across the county of Kronoberg in southern Sweden.

In Sweden county governments preside over healthcare provision, and the deployment of COSMIC across 2 hospitals, 26 healthcare centres, 4 mental health units and 25 dental care centres has meant that 180,000 inhabitants have a unique patient record. The project has been a success, and while political and social conditions are different in the UK, much can be learned.

The Spine could either prove to be one of the greatest inventions of the 21st century or the next Millennium Dome. Time will tell. Either way, Victoria's death five years ago serves as a reminder that the needs of the patient will be better served by greater availability and integration of patient records.

The government's new ContactPoint initiative is, for example, a step in the right direction. Five years on, the UK is still not there, but examples like Kronoberg show that there is hope.

Andrew Meiner, Country Manager UK, Cambio Healthcare Systems www.cambio.se  

Reference

1. The Victoria Climbié Enquiry website:
www.victoria-climbie-inquiry.org.uk/