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Chapter 10, “Children and families”, of the Caldicott Review on information governance in health and social care [1] refers twice to “troubled families”. (The term isn’t used in the chapter 10 section of the executive summary.) Although it says that government is using data to identify such families for early intervention, the chapter – and thus the review – fails to mention explicitly the Troubled Families programme. [2] Because there is a lack of clarity around the programme’s information sharing arrangements, this is a serious omission.
The government established the Troubled Families programme for England in 2012, after the 2011 summer riots. The programme’s definition of “troubled families” poses four problems (at least) for information governance in health and social care. First, it is a highly politicised and contentious definition. [3] Second, the government conflates multiple needs and behaviours: “Troubled families are those that have problems and cause problems to the community around them, putting high costs on the public sector.” Clearly, these families are not a homogeneous group – but government announcements present them as such. Third, the definition is ill-defined and not fixed, for the programme is still at an embryonic stage. Fourth, the Troubled Families programme allows for the first time local authorities to access the benefit records of residents without informed consent. [4]
The Troubled Families programme means that information about patients is not only shared across the health and care system: other departments within local authorities and their external partners are also participants. Further, each local authority works with the Troubled Families team, based in the Department for Communities and Local Government, and other government departments (e.g. to access benefit records). There is an urgent need therefore for more clarity around the information sharing arrangements for the Troubled Families programme. The Health Secretary must address this in his full response to the Caldicott review, due in the summer.
Re: Review recommends duty to share data when in patient’s best interests
Chapter 10, “Children and families”, of the Caldicott Review on information governance in health and social care [1] refers twice to “troubled families”. (The term isn’t used in the chapter 10 section of the executive summary.) Although it says that government is using data to identify such families for early intervention, the chapter – and thus the review – fails to mention explicitly the Troubled Families programme. [2] Because there is a lack of clarity around the programme’s information sharing arrangements, this is a serious omission.
The government established the Troubled Families programme for England in 2012, after the 2011 summer riots. The programme’s definition of “troubled families” poses four problems (at least) for information governance in health and social care. First, it is a highly politicised and contentious definition. [3] Second, the government conflates multiple needs and behaviours: “Troubled families are those that have problems and cause problems to the community around them, putting high costs on the public sector.” Clearly, these families are not a homogeneous group – but government announcements present them as such. Third, the definition is ill-defined and not fixed, for the programme is still at an embryonic stage. Fourth, the Troubled Families programme allows for the first time local authorities to access the benefit records of residents without informed consent. [4]
The Troubled Families programme means that information about patients is not only shared across the health and care system: other departments within local authorities and their external partners are also participants. Further, each local authority works with the Troubled Families team, based in the Department for Communities and Local Government, and other government departments (e.g. to access benefit records). There is an urgent need therefore for more clarity around the information sharing arrangements for the Troubled Families programme. The Health Secretary must address this in his full response to the Caldicott review, due in the summer.
1. Dyer C. Review recommends duty to share data when in patient’s best interests. BMJ 2013;346:f2642. (25 April.)
2. Department for Communities and Local Government. Policy: Helping troubled families turn their lives around. 2013. www.gov.uk/government/policies/helping-troubled-families-turn-their-live....
3. Editorial. 'Troubled families': poverty of argument. Guardian 2012 Jun 12. www.guardian.co.uk/politics/2012/jun/11/troubled-families-eric-pickles-e....
4. Ramesh R. The civil servant who thinks she can fix troubled families. Guardian 2012 Jul 18. www.guardian.co.uk/society/2012/jul/17/louise-casey-troubled-families.
Competing interests: No competing interests