Minimum Standards

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Minimum Standards

• Maureen Dalton

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• What are the minimum medical and other services
  regardless of the venue at which the service
  takes place ?

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Develop standards

• Evidence base to use to develop standards
• Barrister based rather than evidence or victim
  based

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Police
A E
SARC
GUM
Examine Sexual Assault victim
Family Planning
G P
Paediatrician
Gynaecologist
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• One Sunday morning
• Emily (aged 15) arrives, with her parents to
  local police station, stating she was raped the
  previous night.
• No forensic medical examiner (FME) available
• Approach local paediatricians

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• They approach the on call gynaecologist.

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• Is kept waiting 12 hours AT THE POLICE STATION
  whilst they try to find a doctor to see her.
• Sent home to return the next day and not to bathe
• Did not return

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• 3/52 later admitted with Pelvic inflammatory
  disease (due to chlamydia) and positive pregnancy
  test!!!

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• Have the forensic needs taken priority over her
  health needs?
• Was this a victim centred approach?
• Would she have been better going to AE?

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• Most of the country not served by SARCs
• and not offering STI prophylaxis
• J Clin Forensic Med. 2006 May13(4)164-71.

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• In the non SARC services, lack of co-operative
  working with local health services, lack of
  equipment, and lack of 'in house' medical follow
  up arrangements is the norm.
• J Clin Forensic Med. 2006 May13(4)164-71.

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• FME is employed by police
• outsourced
• tight budgets
• 95 custody work

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• Send on a course
• how long?
• 2 weeks
• or 30 minutes?

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• If the parents had wanted to complain about Emily
  not getting after care who should they have gone
  to?

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• When is a SARC a SARC?
• St Marys
• REACH
• HAVENS

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• But is an examination suite and a counsellor a
  SARC?

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• Is sign posting enough for
• emergency contraception
• STI prophylaxis
• HIV PEP
• counselling

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• Governance
• Regional SARC
• Regional network

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• Safeguarding Children and Young People roles and
  competencies of health care staff Intercollegiate
  document April 2006
• .

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When do you become an expert witness?
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• Witness to fact
• Professional witness
• Expert witness

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Coming Soon

• DoH Guidelines on commissioning service for
  victims of sexual assault
• on managing victims of sexual assault.
• Diploma of competency to manage victims of
  sexual assault
• Doctors Nurses
• Competency based

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Dip FCASA

• Dip FCASA adult
• Dip FCASA children
• Dip FCASA adult and children

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Dip FCASA

• RCOG
• RCPCH
• FFLM
• FSRH
• BASHH
• BAEM/CAEM
• RCPsych

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counselling

• guidance for note-taking recognised as 'no -
  notes' (acceptable if within a policy),
• 'minimal notes' (usual in many psychhological
  therapies) extensive/expansive' (often used in
  psychotherapy/play therapy etc)

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• the Crown Prosecution Guidelines for Pre-trial
  Therapy 2001 (revised).