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Honouring the lived experience: Rape and Sexual Assault‎ Victims Taskforce option appraisal report

A report summarising the approach, methodology, findings and recommendations of the options appraisal exercise carried out in June 2018 as part of the Chief Medical Officer's Taskforce to Improve Services for Victims of Rape and Sexual Assault.


9. Plenary Session

Following on from the groupwork scoring process in the afternoon we opened up a plenary session for feedback from each of the groups. The groups were encouraged to explore anything that had not been in scope for the process and event so far to enable attendees to feed into the next steps for the work.

Services

  • There needs to be crystal clear accountability and governance. This is easier to do with local delivery of services (with co-ordinated service/centre to support local delivery at regional level). This is a service not necessarily bricks and mortar
  • The services should be age appropriate.
  • Services in Orkney would benefit from the support of a centre of expertise
  • Local services need adequate funding to ensure no variation in quality.
  • There needs to be consistent decent pathways of care so that patients and staff know what to expect. The additional bit of the pathway around the justice side can be traumatic, criminal justice needs improvement (that's not for today)

Children

  • There was a discussion around children and the legal age vs. age of consent.
  • Need to link this work with developments around Barnahus model.
  • Request that the child age in brought into line with International Definition.
  • Local services for children - importance of secure and trusting relationships between child and professional (s) involved in their care (Children's 1st)
  • How does the advocacy support for children fit in with existing children's services and MCNs? Suggestion to migrate from managed clinical networks to managed care networks for child protection (more multi-agency).
  • Reassurance required that whatever is recommended would not unpick the work going on around children. We need to be very aware of the risk around children and make sure that any decisions don't undermine the work that has gone over the past decade.
  • A plea that any option going forward for consideration will sit with the wider child protection sphere, it's not just the crown but can also be called to a child protection hearing. We're meant to be protecting children.
  • Reassurance that models put forward won't dissemble, be detrimental to any current structures for children, will only build on them.

Training

  • Need to tie in with work that NHS Education Scotland (NES) has done on trauma informed services (NB: this is now weaved through the 2 day NES introduction to Sexual Offence Examinations course but could feature more predominately in detailed service specifications as they are developed).

Workforce

  • Regarding female workforce, there is overwhelming evidence for female doctors but there are some exceptions.
  • Need to give victims a choice (men and boys) -
  • Advocacy worker not the only model. What about developments around healthcare co-ordinators?
  • We need to ensure that the justice side is remembered. Need to gather admissible, reliable evidence. Whatever the system we need to have well-trained and experienced FMEs so they can give expert opinion in court. The challenge of local delivery and maintained expertise, if they are only required to do one or two examinations a year it could lose expertise. Frequency = expertise.

Configuration

  • Regional centres not suitable for Police Scotland
  • Regional model too wide for the North
  • How much of care pathway is regional and local. Immediate support local, facilitated discussions about next steps (FME etc.), follow on care and support local. Travel for FME - if need be.
  • Barnahus model in Denmark - centres of excellence supporting 90+ inhabited island communities.
  • The group felt that multiple centres for excellence were a good idea, but suggested more than 3 are necessary.

General

  • Trauma informed - 5 principles: safe/trustworthy/rapport/collaboration/empowering.
  • Suggestion that the Quality Criteria Safe could be both physical and emotional
  • Archway grab bag model could be looked at for hard to reach areas
  • Moving forward, the group have hope that the CMO taskforce team will be able to reassure them that this new option won't be funded locally using existing budgets.

Contact

Vicky.Carmichael@gov.scot

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