Children’s health is shaped by many connected factors: genetics, early life experiences, family and community environments, education, physical health, mental health, and biology. Today, information about these factors sits in many different systems that cannot easily be analysed together.

This fragmentation makes it harder to:

• identify problems early
• understand how different factors interact over time
• design services that work for real communities
• develop treatments and technologies designed specifically for children and young people

CADRE is designed to overcome these challenges by securely linking data across sectors, creating a richer, more connected and ethically governed resource that no single organisation could build alone.

By bringing information together at a population level, CADRE helps researchers, clinicians and service planners build a deeper understanding of the challenges children and young people face, in health, at school and in their wider environment.

This insight can support:

• earlier identification of need, before problems become severe
• better‑targeted services and support in the community
• more effective treatments and interventions
• better use of resources, focused where they can make the greatest difference

Over time, this means more children and young people getting the right help at the right time before they reach crisis point.

For example, in one project, Timely researchers will use data from CADRE to help them design a suite of Artificial Intelligence (AI) and digital tools to support professionals such as GPs, social workers or hospital staff to identify young people who might be struggling with mental health but aren’t getting the help that they need.

1. Local health, education and social care services agree to share their data about children and young people with CADRE.
2. Information that can identify a person (such as names, addresses, NHS numbers) is removed and stored separately from clinical data while it is still in local services; this is called pseudonymisation.
3. Once the pseudonymisation has been checked, the pseudonymised datasets are securely fed into the CADRE database.
4. The data is linked together and securely stored.
5. Within CADRE, data is converted into a common format and organised so researchers can use it more easily.
6. Separately, the identifiers – which will be needed to re-identify a person in specific circumstances – are also securely fed into the CADRE database and stored in a distinct environment which will never be accessible to researchers.
7. A researcher sends a request to use relevant data for a project, based on a specific research question.
8. Access to the pseudonymised database will be granted to researchers under very specific circumstances through a screening and approval process.
9. If the project is approved, the researcher is given limited access to those areas of the pseudonymised database they need for their project and given training on how to use it properly.
10. Where a research project would benefit greatly from further information from the patients, approved researchers, may search the database for pseudonymised records meeting their inclusion criteria to request re-identification. In these circumstances, the child and/or their parent/guardian will be contacted through their clinician to obtain their consent to be contacted by the researcher. The researcher cannot view the child’s clinical records and contact the family without prior consent.

At every stage, CADRE operates within strong ethical, legal and public‑sector governance frameworks, with data providers retaining control of how their data is used.

Keeping children’s and young people’s information safe is central to how CADRE works.

We use the Five Safes framework, which is a set of principles that allows data services to provide safe research access to data. The framework is considered best practice in data protection and is used by a range of other similar databases across the UK including Health Data Research-UK (HDR-UK) and the National Institute for Health Research Design Service (NIHR). Find out more about the Five Safes framework. The principles are described below.

The Five Safes

1. Safe data: data is pseudonymised to protect patient confidentiality.
2. Safe projects: research projects are approved by the data access committee for the public good.
3. Safe people: researchers are trained and authorised to use data safely.
4. Safe settings: CADRE is hosted on a Secure Data Environment (SDE), which prevents unauthorised access or use.
5. Safe outputs: screened and approved outputs do not disclose personal data.

There’s more information on the Understanding Patient Data website.

Together, these safeguards ensure that data is used ethically, securely and transparently, and only in ways that aim to improve the health and wellbeing of children and young people.