Children's 'red books' start to go online from April

Monday, February 13, 2017

The ‘red book’, the paper-based personal child health record for under-fives, will be available online for London parents from April ahead of a national rollout.

The electronic version will be known as the eRedbook and is the UK’s first digital Personal Child Health Record.

It is part of the wider move to transforming the way technology is used to enable health professionals, parents and carers to share data via new electronic hubs.

Kenny Gibson, head of public health commissioning, NHS England, said, ‘It’s our role to begin offering every parent the opportunity of launching the electronic version of the red book. We know since the red book was launched by Harlow printing and the red book board, parents love the red book.

‘It’s a go-to place but historically it was always given in the delivery suite when mum had just pushed out baby, she was handed the red book and told to get on and understand it.’

Mr Gibson was speaking at the Govconnect Early Years 2017 conference on children’s health at the Royal School of Medicine in London.

The online version of the red book in London will become the blueprint for other local authority areas and is seen as critical as the system moves from paper to electronic online records.

Mr Gibson said, ‘So from 1 April there is no reason why every parent in London cannot launch their own electronic health record – or in London we call it the eRedbook.

‘It’s been field tested in four sites at the moment and another three sites are prototyping the screening results.

‘[There is] awe and wonder on parents' faces when they open up their smartphone, or the computer in the children’s centres, and they see their child’s health vaccinations pop up and they suddenly begin owning their child’s public health indicators.

‘This will become the blueprint – all the technical solutions, the build, will be sent to every region, and importantly every local authority commissioner, because part of the problem at the moment is whilst local authorities are commissioning health visiting, what they are not doing is commissioning a system that allows you as health visitors to robustly manage it.

‘So we have got to begin working with local authorities very quickly to say when you are commissioning early years they must have a clinical system that must connect with every other part of the early years system – otherwise you’re delivering health visiting without technology, and you’re delivering in a vacuum.’

Guidance will also be launched at the end of March.

Mr Gibson also said that the NHS was exploring how parents could add data online to their child’s health records.

‘Regardless of how large or how little the public health grant is, some services aren’t able to capture that moment of baby’s first steps,’ he said. ‘And so we’re beginning to work with parents to understand how does the parent themselves feed digital records by ages and stages – or we all know them milestone development checks.

‘So that when they come into contact or contribute to a professional health assessment, they can look at 18 months, two and a half months, three and a half years with real live evidence - video, photographs etc. because the parent might be able to capture it on their smart technology.’

The NHS vision is that by 2020 there will be a child health hub in every region.

Health professionals, the healthy child programme, including, neo-natal intensive care units, would feed the hub with data.

Mr Gibson said that it was the ‘ridiculous situation in 2017’ that a file from a NNICU cannot be shared with health visitor because it is in the wrong format.

This is despite the fact that there is a mandate under the Children’s Act section 12, chapter 14 to use informatics for the benefit of safeguarding children.

‘There is a wealth of data – as some would say we’re data-rich, but I would say, as a commissioner and as a midwife, we’re actually intelligence-poor around the child because no-one has ever collected it together and held it in a central place where the parents can get ownership,’ Mr Gibson said.

‘As digital data becomes more relevant then it grows. Yes, we’ve got 58 bits of data on every child now captured, but in London we have 136,000 live births every year. And that grows. By the age of five or six we have 5.2m data points in London on our under-five cohort.’

He added that every professional should have a core data set for parents and families.

‘Every domestic homicide review, every part eight child death review I read, a broken record is implicated in us not catching that incident earlier. So we need to be doing that.’

Early years settings

During a question and answer session, one delegate said that she was involved with piloting the integrated review approach and the health review and EYFS progress health check in Thanet, in Kent.

‘I’m very interested about the eRedbook launch. What we found in nurseries in Kent is there’s so little use of those red health books. But they’re a very useful starting point for before children arrive through the door.

‘So we’re promoting that as a useful tool and to reignite parents’ interests in those books. How will that be affected if it becomes an e-book? How do early years settings access that information?’

She added that the term early years was being used in the context of the health agenda and that terms such as digital child health hub narrow down the whole early years agenda to health. She suggested that terms such as 'health and learning' or 'health and development' could be used, so the whole early years sector would feel included in that partnership.

Mr Gibson said, ‘I couldn’t agree more. It has to be an integrated record eventually. What we’ve chosen to do is to fix the high risk areas – there were children in children’s centres with no failsafe on vaccinations. No failsafe on their screening results. And that had to be fixed first. The next is children that are acutely ill. The next education ready assessment will have to come in. So we’re biting off each part of that jigsaw over the next few years. Until 2020 when we think most things will have come in.’

‘There will always will be parents that don’t want to go digital - £2.70 for each paper red book, an independent cover for an organisation £3.80, eRedbook less than £2. And you can fix it and update it quite quickly. We reckon that because most parents are digital savvy on Amazon, Pinterest, Twitter all the time – we feel that they will have greater confidence, because it looks like a Facebook page.

‘Parents will always have a choice of that treasured memory box item, but I think when 2020 arrives, a lot of treasured memory boxes will be on Twitter and be digital, I would surmise.’

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