Victoria’s information sharing reforms: What do PHC nurses need to know?

By APNA Project Officer Jo Millard

Source: APNA Primary Times Summer 2022-23 (Volume 22, Issue 2)


While primary health care (PHC) nurses have been busy caring for their communities during the COVID-19 pandemic, legislative changes in Victoria have introduced information sharing reforms. The new schemes aim to better protect the wellbeing and safety of children and families, and make it easier and faster for health-care professionals to collaborate across organisations and sectors. 

All Australian states and territories are currently improving health- and wellbeing-related information sharing practices. This is largely due to the Royal Commission into Institutional Responses to Child Sexual Abuse (2017), which made national recommendations for improved information sharing and collaboration across sectors to protect children.1 

Reform in Victoria has also been prompted by coronial inquests, child death enquiries, Commission for Children and Young People reports,2 Victorian Auditor-General reports and the Victorian Government Royal Commission into Family Violence (2016), which found that a system-wide approach to improve integration and information sharing is required to effectively support families and children in a timely way.3 

Prior to the implementation of these reforms, it was not easy to share health-related or other relevant information in a timely manner across organisations or sectors to prevent risks from escalating. In some cases, inadequate information sharing contributed to tragic outcomes for children and families. The reforms provide additional information sharing permissions and give precedence to the wellbeing and safety of children over the right to privacy.

The first phase of Victoria’s information sharing schemes was introduced in September 2018. This phase included organisations with workforces from Maternal and Child Health services, The Orange Door, specialist family violence services, sexual assault services, mental health services, and alcohol and other drugs services. The second phase was introduced in April 2021, and includes general practice organisations, government schools, community health services, long day care, kindergartens, and before- and after-school care. All of these organisations are now considered information sharing entities (ISEs): prescribed or authorised organisations enabled through the reforms to share information with each other. For a full list of ISEs, go to the Victorian Government website. 5

  

‘The Child Information Sharing Scheme gives professionals working with children and families the legal permissions to confidently, safely and proactively share information and collaborate to provide early support to children, so wellbeing issues do not escalate into safety concerns.’ 

— Lisa Gandolfo, Executive Director, Victorian Child Information Sharing Scheme, Department of Education and Training 

Victorian PHC nurses are well placed to contribute to community wellbeing and safety by learning about, and acting on, changes to information sharing requirements. As noted by CISS Executive Director Lisa Gandolfo, ‘The CISS encourages nurses working in authorised primary healthcare settings, like general practice, to share information with other authorised services, such as schools, to promote wellbeing and safety of children. Nurses can share and request information to gain a complete view of the child they’re working with. The scheme gives professionals working with children and families the legal permissions to confidently, safely and proactively share information and collaborate to provide early support to children, so wellbeing issues do not escalate into safety concerns.’ 

Nurses working in general practice, community health and schools can use the information sharing schemes to help keep children and families safe. The information shared should be relevant to promoting the wellbeing and safety of a child or children as part of the Child Information Sharing Scheme (CISS), and/or to assess or manage family violence risk to adults or children as part of the Family Violence Information Sharing Scheme (FVISS). The reforms anticipate that professional judgement will guide what information is relevant and safe to share. 

The CISS and FVISS provide additional permission to share information and they complement existing laws. It’s important to note that obligations such as mandatory reporting still apply. The CISS ensures that professionals working with children can gain a complete view of the children they work with or care for, making it easier to identify and act on wellbeing or safety needs earlier.6 In addition to this, the information sharing reforms are designed to: 

  • promote an environment of collaboration and shared responsibility for the wellbeing and safety of children, young people and families 
  • enable earlier identification of at-risk individuals and groups 
  • enhance professionals’ abilities to meet child wellbeing and safety obligations, including child safe standards and mandatory reporting, as it is possible to seek and access relevant information 
  • facilitate earlier support and engagement with relevant services 
  • support a coordinated and integrated approach to service delivery across the service sector.4 

 

Excluded information 

Excluded information is information that cannot be shared under the CISS or FVISS, such as information that may endanger a person's life or result in physical injury; prejudice legal proceedings, a police investigation or a coronial inquiry; or contravene a court order. Information that is subject to legal professional privilege is also excluded from the schemes and ISEs must not share information that would contravene another law that has not been overridden by the schemes. For more information, go to the Victorian Government’s website.7,8

The Victorian Government offers online training in how to comply with the new information sharing and family violence reforms. Go to https://training.infosharing.vic.gov.au to do the online course. 

 

ISEs’ responsibilities 

ISEs are responsible for ensuring that their organisational policies and practices are consistent with the CISS and FVISS ministerial guidelines.9 Some considerations for prescribed PHC settings include those listed in Table 1.  

The following documentation is required when information is shared: 

  • Date information was requested/shared 
  • ISE requesting/receiving information 
  • The information requested/shared 
  • Whether the views of the child/family were sought about the information sharing and, if not, the reason why 
  • Whether the child/family was notified that their information was shared 
  • For FVISS where no child is at risk: Whether consent was obtained from the adult victim survivor/third party to share information and, if not, the reason why, and whether the person was notified that their information was shared without consent  
  • Any relevant risk assessments or safety plans that have been prepared for a person at risk of family violence. 

 

Case study example: 

Nine-year-old Dillon attends the local general practice with pains in his stomach. The general practice nurse, Tayla, notes that Dillon has attended the clinic several times in the last 6 months with similar symptoms and she informs her colleagues. 

Tayla undertakes the agreed biomedical and general assessment. During the assessment, she asks Dillon about school, and he reveals that he is being picked on by some other kids. Mum (Faye) is aware of the bullying, but didn't realise that it could be causing Dillon's physical symptoms. Tayla discusses information sharing arrangements with Faye. She explains that the clinic can share information about the bullying with Dillon’s school, which would prevent Dillon from having to retell his story and relive painful experiences. Mum appreciates Tayla’s clear explanation and agrees to the suggestion.  

In this scenario, there are no excluded information considerations and information sharing will assist with setting up wraparound support services. In keeping with the organisation’s information sharing policies and procedures, Tayla contacts the nurse at Dillon’s school and shares relevant information about his experience of being bullied. She also shares information about the health-care team’s planned follow-up appointment to check on Dillon’s mental and physical health. Both the general practice and school document the information shared. Tayla also shares Kids Helpline resources with Dillon and Faye.  

The school nurse liaises with the designated school team, including the wellbeing coordinator. Strategies and support are put in place at school, including a problem-solving skills support program to address and minimise the impact of the bullying.  

The ISEs continue to collaborate and share information to support Dillon and ensure wraparound services optimise his wellbeing. 

 

A note for PHC nurses in other states and territories 

Although the information sharing reforms described here are Victorian, child wellbeing and safety is a national priority and family violence doesn’t recognise borders. It is important for cross-border PHC providers and schools to be aware of the information sharing requirements in their jurisdiction as well as those of neighbouring jurisdictions. Please check the APNA website for your state or territory requirements.10

 

Resources for PHC nurses and education and health-care teams 

 

Key contacts 

  • Emergency: 000 
  • RESPECT: 1800 RESPECT or 1800 737 732 or www.1800respect.org.au/ 
  • Kids Helpline Phone Counselling Service: 1800 55 1800 

 

Support for PHC nurses 

  • Nursing and Midwifery Board of Australia, Your Health Matters: 1800 667 877 or www.nmsupport.org.au/. This is a 24/7 independent national support service for nurses, midwives and students. It provides access to confidential advice and referral and has some great resources. 
  • APNA’s Nurse Support: 1300 303 184. 

 

Acknowledgement  

The APNA ‘Improving Child Safety and Wellbeing and Family Violence Outcomes Project’ was supported by the Victorian Government under the Child Information Sharing Capacity Building Grants Program. 

 

APNA’s role 

APNA’s involvement in the Victorian Government Child Information Sharing Capacity Building Grants Program aims to improve wellbeing and safety for children, and improve family violence outcomes by facilitating information sharing across sectors, including PHC. In February 2022, APNA commenced the ‘Improving Child Safety and Wellbeing and Family Violence Outcomes Project’ to raise awareness of the information sharing reforms. The APNA Project is: 

  • providing education sessions, community of practice ‘Nurse Talk’ sessions, and podcasts to raise awareness of the reforms and inform nurses of their role in information sharing  

  • developing resources to support PHC nurses working in authorised organisations, such as general practice. This includes case study guides, an acronym guide, an FAQ resource, and a Child Information Sharing Flow Chart. The resources are located on the APNA Project website: www.apna.asn.au/profession/child-information-sharing-scheme.  

 

Table 1 Actions for information sharing entities (ISEs) to consider for compliance with the reforms 

Steps 

Sub-steps 

Develop a clear plan for information sharing practices  

 

  • Collaborate with your team to develop your information sharing plan 
  • Determine your organisation’s information sharing goals 
  • Clarify your understanding of organisations that are ISEs 
  • Learn how to request or respond to an information sharing request 
  • Learn how to proactively share information with appropriate organisations to promote child wellbeing and safety or to assess or manage family violence risk 

Engagement  

  • Engage with your team to ensure everyone is on the same page for information sharing 
  • Develop an agreed understanding of what child wellbeing looks like for your setting 
  • Identify information sharing roles and responsibilities 
  • Continue to develop respectful relationships with patients, clients or students related to information sharing  
  • Provide support, resources and referral as appropriate 

Supporting systems and processes 

Develop: 

  • agreed processes for documenting information sharing, consistent with reform requirements 
  • processes to clarify how information sharing requests will be verified as being from ISEs 
  • guidance for determining what information is appropriate to share or request. 

If in doubt about whether the requirements for sharing have been met, seek further information from the other ISE about how the shared information is intended to be used. 

Best-practice care 

  • Use evidence-based care and guidelines for information sharing4 
  • Identify champions to undertake information sharing training 
  • Adopt or develop information sharing templates for requests or responses 
  • Build team awareness of excluded information that cannot be shared under the CISS or FVISS and of information that may be beneficial to proactively share with other ISEs 
  • Be aware of documentation requirements 
  • Become informed. Undertake information sharing training: https://training.infosharing.vic.gov.au  

Location and facilities 

  • Ensure patient privacy for information sharing conversations 
  • Where appropriate and safe, keep patients/clients informed, but be aware that consent is not required for sharing information under the CISS 

Funding/financial considerations 

  • Schedule protected time for developing information sharing processes 
  • Ensure your organisation meets requirements for responding to or making an information sharing request 

Staffing and HR  

  • Clarify information sharing roles and responsibilities for information sharing response or request processes 
  • Clarify understanding of ISEs with the team 

Evaluation and improvement 

  • Be clear about what it is your organisation is setting out to achieve, how your organisation is supporting child wellbeing and safety and how you will measure whether your workplace is effectively sharing information. 

Note. This table has been adapted from the APNA Nurse Clinic Building Block planning framework. 

 

 

References

1. Australian Government, Royal Commission into Institutional Responses to Child Sexual Abuse, ‘Final report – Recommendations’, Royal Commission website, 2017, accessed 17 October 2022. www.childabuseroyalcommission.gov.au

2. Victorian Government, Commission for Children and Young People (CCYP), ‘Systemic enquiries’, CCYP website, accessed 6 June 2022. https://ccyp.vic.gov.au

3.  Victorian Government, ‘About the Royal Commission into Family Violence’, Victorian Government website, accessed 17 October 2022. www.vic.gov.au

4.  Victorian Government, ‘About the information sharing and MARAM reforms’, Victorian Government website, accessed 6 June 2022. www.vic.gov.au

5.  Victorian Government, ‘Information sharing entity list’, Victorian Government website, accessed 6 June 2022. www.vic.gov.au

6. Australian Government, Australian Institute of Family Studies (AIFS), ‘Mandatory reporting of child abuse and neglect’, AIFS website, accessed 6 June 2022. https://aifs.gov.au

7.    Victorian Government, ‘Frequently asked questions about information sharing and MARAM’, Victorian Government website, accessed 6 June 2022. www.vic.gov.au

8.  Victorian Government, ‘Overview of the Family Violence Information Sharing Scheme’, Victorian Government website, accessed 6 June 2022. www.vic.gov.au

9. Victorian Government, ‘Child Information Sharing Scheme Ministerial Guidelines’, Victorian Government website, accessed 6 June 2022. www.vic.gov.au

10. APNA, ‘Child Information Sharing Scheme’, APNA website, accessed 17 October 2022. www.apna.asn.au

 

The Australian Primary Health Care Nurses Association acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respects to elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.


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