Application for Adult Psychiatric Morbidity Survey (APMS)

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Objective for processing

The Children's Commissioner's Office (CCO) requires the 2014 Adult Psychiatric Morbidity Survey (APMS) to conduct a review of the aggregate numbers of children living in households where certain adult or parental vulnerabilities are present. In particular the CCO wishes to provide quantitative evidence on the numbers of children living in households where an adult or parent has reported one or more (and various combinations) of the following conditions: - Physical health problems and disabilities - Mental health problems and disabilities - Alcohol misuse issues - Substance misuse issues - Domestic violence and abuse This analysis is not contained in any existing published analysis of the APMS 2014, which focuses solely on (i) measuring these vulnerabilities in terms of the numbers of adults affected; (ii) considering each issue in isolation rather than looking at the prevalence of multiple co-occurring vulnerabilities. Hence the analysis the CCO wish to produce and report is only possible by doing new analysis of the underlying APMS dataset. This project is being undertaken as part of the Children’s Commissioner’s Business Plan for 2018-19 as part of the CCO’s programme of work on measuring Vulnerability. This programme of work has revealed that children living in households where several of these adult conditions are present are exceptionally vulnerable themselves, and yet there is next to no evidence on the actual numbers of children who may be affected. The CCO do not have a national prevalence measure of the number of children in living in households where parental mental health, parental alcohol and substance misuse, and parental drug and alcohol misuse are all present – the so-called ‘toxic trio’. This is despite the fact that these issues are often placed as key drivers of growing demand on public services, most notably the police, children’s mental health, hospital Accident & Emergency, and children’s social care. Hence the proposed research is expected to fill in a major evidence gap that is of interest to various government departments and agencies including the Department of Health and NHS England. The CCO will be processing the data under Articles 6(1)(e) and 9(2)(j) of the GDPR. Key findings will be published in a report, used for briefings and evidence submissions to government departments. The CCO do intend to publish or share any disclosure information: the report will focus only on aggregate statistics including graphs and percentages. The publication deadline is the beginning of July; a draft of the report will be shared with NHS Digital both for information and to give NHS Digital the chance to comment if desired. The Children's Commissioner's Office (CCO) requires the pseudonymised 2014 Adult Psychiatric Morbidity Survey (APMS) to continue the review of the aggregate numbers of children living in households where certain adult or parental vulnerabilities are present. In particular, the CCO wishes to continue to provide quantitative evidence on the numbers of children living in households where an adult or parent has reported one or more (and various combinations) of the following conditions: - Physical health problems and disabilities - Mental health problems and disabilities - Alcohol misuse issues - Substance misuse issues - Domestic violence and abuse This analysis is not contained in any existing published analysis of the APMS 2014, which focuses solely on (i) measuring these vulnerabilities in terms of the numbers of adults affected; (ii) considering each issue in isolation rather than looking at the prevalence of multiple co-occurring vulnerabilities. This project is being undertaken as part of the Children’s Commissioner’s Business Plan for 2020-21 as part of the CCO’s programme of work on measuring Vulnerability. This programme of work has revealed that children living in households where several of these adult conditions are present are exceptionally vulnerable themselves. The CCO has previously used the APMS data to produce national and local prevalence estimates of the number of children living in households where parental mental health, parental alcohol and substance misuse and parental drug and alcohol misuse are all present – the so-called ‘toxic-trio’. These estimates have been made available to users, including local authorities, through the CCO CHLDRN web app available at: https://www.childrenscommissioner.gov.uk/chldrn/ The Children’s Commissioner is the only source of these estimates currently and through the 2020-21 business plan has committed to producing updated estimates for 2019/20, so that local authorities and decision makers can have access to the data for their area which can be used to inform local and national policy. The APMS 2014 is the only data source available which provides the information required to carry out the estimation of the ‘toxic-trio’. This data collection is necessary to deliver a project on the Children’s Commissioner’s 2020/21 Business Plan, hence it is necessary for the Commissioner to deliver her statutory functions. This data is collected under CCO’s statutory powers – section 2F of the Children’s Act 2004 which states: (1) Any person exercising functions of a public nature must supply the Children’s Commissioner with such information in that person’s possession relating to those functions as the Commissioner may reasonably request for the purposes of the primary function or the function under section 2D. (2) The information must be information which that person would, apart from subsection (1), lawfully be able to disclose to the Commissioner The Children’s Act 2004 Section 2 sets out the statutory role of the Children’s Commissioner for England: Primary function: children's rights, views and interests (1) The Children's Commissioner's primary function is promoting and protecting the rights of children in England. (2) The primary function includes promoting awareness of the views and interests of children in England. (3) In the discharge of the primary function the Children's Commissioner may, in particular— a) advise persons exercising functions or engaged in activities affecting children on how to act compatibly with the rights of children; b) encourage such persons to take account of the views and interests of children; c) advise the Secretary of State on the rights, views and interests of children; d) consider the potential effect on the rights of children of government policy proposals and government proposals for legislation; e) bring any matter to the attention of either House of Parliament; f) investigate the availability and effectiveness of complaints procedures so far as relating to children; g) investigate the availability and effectiveness of advocacy services for children; h) investigate any other matter relating to the rights or interests of children; i) monitor the implementation in England of the United Nations Convention on the Rights of the Child; j) publish a report on any matter considered or investigated under this section. This statutory function to collect data and the primary function of the Children’s Commissioner as set out in the legislation (relevant sections highlighted in bold above) relates directly to Articles 6 and 9 of the GDPR act. The CCO will process this data under Article 6(1)(e), processing data in the public interest, and 9(2)(j), processing special category data for the purpose of scientific inquiry. This body of research investigates important issues affecting many children who would not, without the Children’s Commissioner, be able to have their rights, interests and views represented to government and policy makers. The special category data which will be collected will not be linked to an identifiable child and will not be shared beyond the Office of the Children’s Commissioner except in aggregate, disclosure controlled, statistical tables as part of the Commissioners report on the issue. Key findings will be published in a report, used for briefings and evidence submissions to government departments. The CCO do intend to publish or share any disclosure information: the report will focus only on aggregate statistics including graphs and percentages. The publication deadline is the beginning of July; a draft of the report will be shared with NHS Digital both for information and to give NHS Digital the chance to comment if desired.

Processing activities

NHS Digital will permit CCO to download the pseudonymised record level 2014 APMS dataset from the UK Data Service, and will also authorise NatCen to provide to CCO the linked household grid variables so that the numbers of children in households, and links between parents and children, can be assessed. The household grid contains age, marital status, gender and relationship status for all members of the household. No personal identifiable data is involved at any point. The data will be stored on the Department for Education secure network on a secure folder with restricted access, only accessible to certain individuals through password-protected staff accounts on password-protected and Bitlocker-encrypted devices. The data will be accessed only by individuals within the Children's Commissioner's Office Evidence Team, all of whom are substantively employed by the Children’s Commissioner’s Office. All Children’s Commissioner staff members have information security training and enhanced DBS checks. The data will not be used for any other purpose beyond the classification and measurement of adult vulnerabilities as described in the Objective for Processing, and in the quantification of the numbers of children exposed to those vulnerabilities. The raw data will not be shared with any third parties. Any reports made available outside of the Children’s Commissioner’s Office will be subject to the CCO’s disclosure control rules including suppression and rounding. Dependent on the findings, the Children’s Commissioner’s Office might want to discuss their analyses with other parties on a more granular level which may involve disclosure of low cell counts. These parties will be limited to government departments (e.g. Department of Health), other public agencies (e.g. NHS England, NHS Digital, police forces), and NatCen (for peer review and quality assurance purposes). Should the need arise, these would be private discussions hosted by the Children’s Commissioner’s Office. Every care will be taken to protect the anonymity of individuals. No third party will be given access to raw data and third parties will not be able to take any information away from the discussion that could put patient confidentiality at risk. All organisations party to this agreement must comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data). The Data will only be used for the purposes described in this agreement. NHS Digital will permit CCO to continue to retain the pseudonymised record level 2014 APMS dataset, previously downloaded from the UK Data Service. NHS Digital will also permit CCO to retain the household gird variables previously provided by NatCen, so that the numbers of children in households, and links between parents and children, can be assessed. The household grid contains age, marital status, gender and relationship status for all members of the household. No personal identifiable data is involved at any point. The data will be stored on the Department for Education secure network on a secure folder with restricted access, only accessible to certain individuals through password-protected staff accounts on password-protected and Bitlocker-encrypted devices. The data will be accessed only by individuals within the Children's Commissioner's Office Evidence Team, all of whom are substantively employed by the Children’s Commissioner’s Office. All Children’s Commissioner staff members have information security training and enhanced DBS checks. The data will not be used for any other purpose beyond the classification and measurement of adult vulnerabilities as described in the Objective for Processing, and in the quantification of the numbers of children exposed to those vulnerabilities. The raw data will not be shared with any third parties. Any reports made available outside of the Children’s Commissioner’s Office will be subject to the CCO’s disclosure control rules including suppression and rounding. Dependent on the findings, the Children’s Commissioner’s Office might want to discuss their analyses with other parties on a more granular level which may involve disclosure of low cell counts. These parties will be limited to government departments (e.g. Department of Health), other public agencies (e.g. NHS England, NHS Digital, police forces), and NatCen (for peer review and quality assurance purposes). Should the need arise, these would be private discussions hosted by the Children’s Commissioner’s Office. Every care will be taken to protect the anonymity of individuals. No third party will be given access to raw data and third parties will not be able to take any information away from the discussion that could put patient confidentiality at risk. All organisations party to this agreement must comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data). The data will not be linked to any other data sources nor matched to publicly available data. The Data will only be used for the purposes described in this agreement.

Expected output

[2 paragraphs unchanged] 2. A short written note containing methods, findings and policy implications This work will feed into the CCO's wider project on Vulnerability which will be published in July 2018 with a launch in Parliament. This particular data analysis may inform that, but will only form a very small part of it – the wider project has been ongoing since 2017. A child-friendly version of the findings may be additionally published in a format targeted to a younger audience (e.g. YouTube video). 2. A technical note containing methods, findings and policy implications A summary of the project and its findings will be included in the Children’s Commissioner’s annual report to parliament (which is a statutory requirement). Findings may also be shared with other public bodies in the event that public bodies have a legitimate interest and request evidence submissions. Outputs will contain no raw data and will contain only derived information in the form of aggregated statistics, tables, graphs and visualisations. All outputs will be compliant with CCO disclosure control rules including suppression and rounding. 3. Updated estimates provided through the CCO CHLDRN web app: https://www.childrenscommissioner.gov.uk/chldrn/ A child-friendly version of the findings may be additionally published in a format targeted to a younger audience (e.g. YouTube video). A summary of the project and its findings will be included in the Children’s Commissioner’s annual report to parliament (which is a statutory requirement). Findings may also be shared with other public bodies in the event that public bodies have a legitimate interest and request evidence submissions. Outputs will contain no raw data and will contain only derived information in the form of aggregated statistics, tables, graphs and visualisations. All outputs will be compliant with CCO disclosure control rules including suppression and rounding.

Expected measurable benefits

The information is required to support the Children’s Commissioner’s statutory remit to [20 words unchanged] at risk of requiring expensive and statutory interventions to keep them safe. The findings will be used to inform policymakers across Whitehall, including in the Department of Health, the Department for Education, and the Home Office. The ultimate benefit from this work will be to improve local and national services for families with complex needs. The findings will be used to inform policymakers across Whitehall, including in the Department of Health, the Department for Education, and the Home Office. The estimates of the number of children vulnerable due to the ‘toxic-trio’ at the local authority level will be provided to local authorities through the CHLDRN webapp to inform their assessments for their Joint Strategic Needs Assessments. Local authorities will then have access to quantified estimates of the number of children at risk in their area, which will enable them to develop local initiatives to support these families. The ultimate benefit from this work will be to improve local and national services for families with complex needs.

Benefits reported

Not stated in the previous version; added here.

The local area toxic trio estimates produced by CCO were incorporated into central government dashboards for most at risk areas during the COVID-19 lockdown. The data have also been submitted to various enquiries related to the toxic trio. The data provided through the CHLDRN webapp have been used by local authorities to inform their Joint Strategic Needs Assessments.

The CCO research into the 'toxic-trio' has generated further research from other organisations including ONS's publication on 2nd November 2020 titled 'Childhood vulnerability to victimisation in England and Wales: year ending March 2017 to year ending March 2019'. This further research would not have been carried out without CCO's pioneering work on this topic.

Throughout the 2020/21 Coronavirus pandemic, understanding the risks faced by vulnerable children has been crucial to ensuring that services continue to be delivered effectively. The toxic-trio analysis has been used by CCO to campaign for the rights of vulnerable children.

Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Changed only in punctuation, spacing or capitalisation: Expected measurable benefits, Expected output, Objective for processing, Processing activities.