A big step for father-inclusion: linking NHS father-child health records
- lora.couzens
- 5 days ago
- 4 min read
Updated: 2 days ago
The belief that only mothers look after children is so baked into the services and systems that surround UK families, it’s almost impossible to imagine that things could be done differently, Jeremy Davies writes.
Symptoms of the ‘Computer says no, dad’ culture include:
Schools phoning mum when children get sick, despite the family explicitly asking them to phone dad.
Health professionals asking ‘where’s mum?’ when a dad brings their child to an appointment (and employers posing the same question when he asks for time off to do so).
Social work departments holding case conferences to determine children’s future, and only inviting the mother.
The Fatherhood Institute does its best to cure public services of their in-built ‘mother default’ through training and consultancy, and advocating for policies, infrastructure and practice to support father-inclusion.
And this month we’re celebrating a major win for our Looking out for dad campaign: an infrastructural change coming soon to a health service provider near you - the linking of NHS father-child health records.
A historic moment
When a baby is born, a new health record – with a new NHS number – is created for them. It’s linked to the mother’s health record (and NHS number) from birth, via a process defined in this guide. This allows health professionals to access information about the child and one of its birth parents.
From December, NHS England will start to also add fathers and second parents to children’s health records, using data from birth registrations.
We are not yet clear how linkage of the father’s NHS number (this is not collected at birth registration) and his phone/email contact details (on health records) will be achieved, but we’ll be finding out: so watch this space!
This significant step forward in NHS father-child health records linkage was confirmed by health minister Baroness Merron in an answer to a Parliamentary Question put forward by Lord Farmer. This is a historic moment: the first time the NHS has formally recognised that fathers' health, like mothers', is intertwined with their children's; and a vital step towards a safer, joined-up system.
But it’s only a partial solution to the problem. Here’s why:
There will be a time lag (of at least a few weeks, and possibly several months) after the birth, for birth registration data to become available on the child’s health record. During this time an infant may be at risk, and the father may not be known to whatever service is engaged on the case. So vital opportunities to engage with him may still be missed.
Fathers who don’t appear on the child’s birth certificate (around 5% of children born in the UK every year) tend to be the most vulnerable (and potentially more likely to present a risk to the child). Because these fathers’ details won’t be included in birth registrations, they will also not be entered on the child’s health record from that source.
Also, birth registration data includes only names, dates of birth and home addresses – not NHS numbers, phone numbers or email addresses. Since the home address many fathers give at birth registration may differ from that on their NHS record (often recorded even years earlier), it’s likely that there will be a significant level of mis-match – which may result in ‘Computer says no!’ moments for many potential father-child linkages. Again, such variation may be greater among more vulnerable fathers, who may be more likely to have changed address since last registering with or accessing the health service.
For these reasons, we’ll be continuing to push for additional measures to maximise the chances of successful father-child health record linkage.
Towards ‘Computer says YES!’
An obvious option would be for maternity services to add the father’s details to the birth notification, alongside the mother’s. This could bring several advantages:
No time lag.
Higher rates of father-child health data linkage, where fathers who don’t go on to jointly register their baby’s birth yet who are known to maternity services (having attended the birth, scans or antenatal appointments) are nevertheless successfully added to their child’s health record – with all that this implies for potential safeguarding and children’s future health.
Even higher rates of joint birth registration, which may support improved family outcomes moving forward: the conversation with a father to gain consent for his name being entered on the birth notification may nudge some unmarried fathers towards joint birth registration (and thus to Parental Responsibility) (Note 1)
The ‘birth notification linkage’ conversation would also provide a clear rationale and opportunity for additional engagement with dads in maternity services: from light-touch information provision, signposting and ensuring contact details on health records are up-to-date (with all fathers) to additional identification and support (with a few – the most vulnerable), together with sharing of concerns with other services about safeguarding and family vulnerabilities, if indicated.
This approach, in addition to the planned birth registration route, needs to be resourced: maternity professionals’ time is precious, and their focus is rightly on mothers’ and babies’ health, so extra time engaging with dad can feel like a luxury.
Policymakers please note: this is not a zero-sum game. Fathers’, mothers’ and babies’ health are – as the move to father-child data linkage through birth registration data finally recognises – closely connected. So the earlier and more systematically health professionals engage with expectant and new fathers, the more likely we are to achieve holistic family support within maternity services and beyond.
Linkage through birth registration data is a big step forward. But even the best data systems are only as effective as the people who use them, so investment in practitioner time and training (to convey to practitioners why and how to use the linked father records, and how to engage with fathers) will also be vital if we want the ‘Computer says no, dad’ culture to disappear.
And so…we celebrate, and we push for better.
Notes
Note 1 Our Parental responsibility and birth registration factsheet – part of our Fatherhood Factsheets series - provides more detail.
