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Supporting children and young people who may have experienced child sexual abuse - clinical pathway: consultation analysis

An analysis of the responses to the consultation on the draft Clinical Pathway for healthcare professionals working to support children and young people who may have experienced child sexual abuse.


Section 5: Appendices

Do you have any comments on the appendices of the pathway document?
ID. Consultation comment Clinical pathways subgroup response
64HR-C Looks comprehensive Noted.
64HN-8 Clearly laid out Noted.
64HF-Z They are helpful and informative Noted.
64HD-X Lots of information Noted.
641R-N The Children’s Hearings (Scotland) Act 2011 should be added to Appendix B: Legal Context. The comment has been noted and the reference added in the Pathway.
6417-T 'Honouring the Lived Experience' appendix, -
1. Executive Summary, para 3, refers to '....access to recovery for anyone who has experienced rape....' yet at 4. Case for Change, para 2 - reference is made to
'women's physical, mental, sexual and reproductive health'. Is this document referring to all genders or women only?
The Pathway has been revised to ensure the vision of the Taskforce for consistent, person-centred, trauma-informed healthcare and forensic medical services and access to recovery for anyone who has experienced rape, sexual assault, or child sexual abuse in Scotland is clear.
641Z-W This refers to the named person where it is not clear who that is or indeed if it is operational in every Local Authority area The revised Pathway now includes a section on the roles and responsibilities of the professionals involved.
641U-R Useful resources Noted.
641T-Q Useful to have access to links providing further information on the legal context surrounding children who have disclosed sexual abuse. Noted.
6418-U The document is titled Clinical Pathway for Children and Young People who have disclosed sexual abuse: This pathway is relevant for children under 16 years of age (or up to 18 years of age for young people with vulnerabilities and additional support needs). However, in the appendix the definition of a child doesn’t specify/distinguish children and young people with vulnerabilities or additional support needs. This can be confusing when applying the definitions to young people aged 16-18. Furthermore, it should reference the Children and Young People (Scotland) Act 2014 which considers the definition of a child. Consent and the age of a child/young person also needs to be considered within the context of this appendix. This should include how to deal with situations if consent is not given, especially if a parent is the suspected perpetrator of the abuse. This appendix also references Getting it Right for Every Child. The links here need to be clearer and clarified. The reference to Named Person Service needs to be considered in light of the on going national discussions and outcomes of the discussions. Guidance on obtaining consent for an examination under various circumstances is included in the Pathway with references for further information if required by health staff.
6416-S ‘Who is a child?’ provides clear information for practitioners and the ‘Legal Context’ is helpful Noted.
6414-Q Helpful resources and links to research. Noted.
64SR-Q Page 22 On reading this again we wondered why we were not suggesting a child is a child until 18th birthday. Wonder if the reference to the Children’s Hearings Act should be the first piece of legislation referred to - child is up to 16 years - and the others explain where there may be variation with children’s procedures being used until 18 years? Page 24 Possibly redundant in light of Appendix A.? combine Appendices A and B? The Pathway is intended to describe best practice in line with current relevant legislation and guidance including age of child.
The Pathway is to be considered an interim pathway and will be subject to review to take account of any changes to relevant guidance or legislation.
64SW-V Useful given the multi-agency context to have these included for reference as needed. Noted.
64SH-D In relation to Appendix B on the legal context, we believe there is value in extending this to children and young people who have been sexually abused, rather than only those who have disclosed, including legal context on grooming and prevention. The two documents below are suggested additions. • Protection of Children and Prevention of Sexual Offences (Scotland) Act 2005 which, among other useful information, refers to Risk of Sexual Harm Orders • Human Trafficking and Exploitation (Scotland) Act 2015 which highlights the issue of children and young people being recruited for the purpose of sexual exploitation. The language in the Pathway is aligned with the draft revised National Child Protection Guidance. It now includes reference to grooming and CSE.
64SU-T It is destructive to the aims of natural justice. Noted.
64SD-9 The legal context and definitions of who is a child are welcome appendices. Noted.
64SP-N In relation to Appendix B: Legal Context, we would refer to our comments on section 4, above. We also note that reference should be made in this appendix to the Adults with Incapacity (Scotland) Act 2000. This Act applies to individuals age 16 and over, and is likely to be of particular relevance to people with “vulnerabilities and additional support needs”, who may have a guardian appointed to them. The pathway document should accordingly take account of the roles and functions of appointees and others under the 2000 Act. It may also be useful to refer in more detail to some of the obligations undertaken by the United Kingdom by ratification of United Nations Convention on the Rights of the Child and Convention on the Rights of People with Disabilities The Adults with Incapacity Act is now referenced.
The Pathway is to be considered an interim pathway and will be subject to review to take account of any changes to relevant guidance or legislation.
64SP-N Table 2 of the consultation provides data for the number of persons proceeded against for sexual crimes relating to children but it is made clear that “convictions / proceedings data does not include any sexual crimes against children where the age of the victim was not specified in the legislation used to prosecute the offender”. It would be helpful to know which offences have been included here, and the possible impact that this method of calculating might have on the statistics. For example, the indication is that these figures would not include, for example, a prosecution of a person for the offence of rape in cases where the victim was an older child (age 13-15) because age of the victim is not specified in section 1 of the Sexual Offences (Scotland) Act 2009. The figures in the Pathway are provided for context only. The primary aim of the Pathway is to promote the delivery of consistent high quality care and support to Children and Young People who have experienced Child sexual abuse and their non-abusing parent/carer(s).
64SQ-P Appendix A is not particularly helpful in what is already recognised as being a complex landscape of legislation for young people age 16 and 17. The listing of the different definitions of a child highlights this complexity and may be confusing for practitioners. We suggest that the final sentence of Appendix A (‘the priority is to ensure that a vulnerable young person who is, or may be, at risk of significant harm is offered support and protection) should be placed at the beginning of Appendix A as an overarching principle so that the services provided are young person centred whatever the legislative basis The pathway has been revised to include more detail on young people aged 16 and 17 years old.
64SQ-P We note that it is the Scottish Government’s intention to bring forward legislation in this parliamentary session to incorporate the UN Convention on the Rights of the Child into domestic law. UN CRC defines a child as an individual who has not attained 18 years of age and current legislation may have to be amended in the light of this. We anticipate that the revised National Guidance for Child Protection will provide further clarity on the issue of protection for 16- and 17-year olds and the Appendix should perhaps refer to that, rather than list current legislation The Pathway is intended to describe best practice in line with current relevant legislation and guidance. The Pathway is to be considered an interim pathway and will be subject to review to take account of any changes to relevant guidance or legislation.
64SQ-P It is not clear how Appendix B will assist practitioners understand the legal context for managing disclosures of sexual abuse. Only the 2014 has an explanatory paragraph. The appendix would be more helpful if a brief explanation is given as to how each of the relevant Acts frame how practitioners should respond to disclosures of sexual abuse or simply give links to the relevant Acts. The final paragraph which explains the 2014 Act sits under the link to the Vulnerable Witness Bill which is potentially confusing The Pathway is not intended to detail the legal context for managing disclosures but provides the links for further information.
64SQ-P The most important thing is that an Interagency Referral Discussion is undertaken to plan a child centred response to disclosures. It would be clearer and simpler to re-state this with reference to the relevant legislation and guidance The definition and role of interagency referral discussions has been expanded in line with the draft revised National Child Protection Guidance, which is currently out for public consultation.
64S4-S The age of the 'child' does not link into UNCRC or to the CYP Act. Many different definitions can cause confusion in relation to the title of the document and what is outlined in the appendix. The Pathway is intended to describe best practice in line with current relevant legislation and guidance.
The Pathway is to be considered an interim pathway and will be subject to review to take account of any changes to relevant guidance or legislation. It will fit in to a wider child protection context described by the revised National Child Protection Guidance for Scotland, which is currently out for public consultation.
64S4-S More detail needed on consent, and what happens when a child or young person is controlled by a suspected perpetrator who must be the person to consent for the medical examination. Need to mention things like child assessment orders, explored in the additional context about what is best for the child. This should be discussed in relation to a child rights issue. All of this is deal with in different documents. Guidance on obtaining consent for an examination under various circumstances is included in the Pathway with references for further information if required by health staff.
64MM-C Consideration would need to be given to local arrangements re: IRD's given that IRD's fulfil different functions across all Local Authorties. Some serve as CP planning other's dont so all LA's will need to ensure their own local arrangements support this pathway. The definition and role of interagency referral discussions has been expanded in line with the draft revised National Child Protection Guidance being going for consultation in 2020.

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