Pathway from womb to work, and beyond

The diagram is from one of the many Getting it right for every child in Lanarkshire documents. It is difficult to read even when it is magnified but it does offer interesting insights into the data tracking and data sharing process which Named Persons will undertake for EVERY child. The Child/young person`s pathway is set out below: 

Step One

At the first visit to a booking in clinic, the Midwife explains to parents that he/she will be the Named Person assessing the parents` capacity to provide wellbeing for their child. The Midwife tracks the baby`s progress through pregnancy, birth and the first two weeks. All available information is gathered from the parents and other maternity staff and used to complete a parental capacity to provide wellbeing assessment.

It is unclear if informed consent for the `parental capacity to provide wellbeing assessment` is required, or what the consequences would be if parents refused to provide all `available information.` However, part of the assessment determines if parents can work with services. Further information about the assessment can be found HERE .

Step Two

At transition to public health, in discussion with parents, the `parental capacity to provide wellbeing assessment` is shared with the Public nurse when the baby is between 10 - 14 days. The Public nurse explains to parents that he/she will become the Named Person, assessing the child`s wellbeing until the child reaches five years old. The child`s wellbeing is tracked through regular health checks, monitoring and home visits. The Named Person in public health keeps a Single Agency Chronology.

Again it is unclear if informed consent is required from the parents by the midwife in order to share the `parenting assessment` with the Public nurse, or whether a discussion is sufficient.  "A Single Agency chronology provides a brief description and summarised account of events in date order...(No) matter how significant or insignificant it may appear itself, (it) can take a greater importance in the life of a child when placed in the context of a time-lined chronology that can be shared."  More information HERE . So the health visitor`s role has broadened to include tracking insignificant life events.
 
Step Three

At transition to local authority nursery, with informed consent, the Public Health Nurse shares information on the child`s wellbeing with nursery staff. A member of the senior management team in the local authority nursery explains that although the Public Health Nurse will remain the Named Person until the child reaches five, nursery staff will be responsible for the child`s wellbeing during nursery hours and will communicate with the Named Person where necessary. Partnership and private nurseries will do the same and, with informed consent, can also request information on the child`s wellbeing from the Named Person.

Now data sharing requires informed consent from parents at the transition to nursery. However there is no mention that informed consent is needed in order for the nursery to communicate with the Named Person. By the time the child is five the Named Person will have accumulated a significant amount of data about the child and his/her family, including an assessment about parenting capacity.

Step Four

At transition to primary school, local authority nursery staff, acting on behalf of the Named Person and in discussion with parents, share information about the child`s wellbeing with a member of the senior management team in the primary school. For children who have not attended nursery, or who attend an independent nursery, the Named Person (public health) will ask for informed consent to share the information available on the child`s wellbeing with a member of the senior management team in primary school. A member of the senior management team in the primary school explains to the parents that he/she will be the Named Person until the child enters secondary school.

It is not clear if `discussion` and `informed consent` are being used interchangeably.

Step Five

At transition to secondary school, in discussion with child/family, a member of the senior management team in primary school shares information on the child`s wellbeing with a member of the pupil support team in secondary. The member of the pupil support team explains to the young person/family that they will be the Named Person responsible for the young person`s wellbeing until they leave secondary school.

Now the child is included in discussion about the data sharing but there is no mention of informed consent.

Step Six

At transition to further education or the world of work, with informed consent, information about the young person`s wellbeing can be shared by the Named Person.

There is a request for informed consent but by this time a child could be 18.

See http://www.girfecinlanarkshire.co.uk/girfec-resources/Item%2015%20The%20child-young%20persons%20pathway/Item%2015av2%20The%20child-young%20persons%20pathway.pdf

Put the wellbeing data gathered by the Named Person together with the profile of achievements which children will build from 3 to 18, and will include their attitudes, values and behaviour since that is what Curriculum for Excellence is about, and GIRFEC reveals the true motivation behind the whole child approach : the total surveillance of the child.

Add that to the proposal to expand the National Health Service Central Register (NHSCR) linked to other public bodies - thus creating a national identity register in Scotland - and we have the totally surveilled citizen - from pre-birth to death.